Utilize Health is an early-stage care management company specializing in populations with complex needs. Our focus is helping those with neurological diagnoses such as traumatic brain injury, spinal cord injury, and stroke.

JOB OVERVIEW

The Manager, Care Management provides leadership, direction, and operational oversight for Care Management Supervisors and Care Managers across the state of Tennessee. This role ensures delivery of high-quality, member-centered care through effective operations, team management, interdisciplinary collaboration, and adherence to company values and regulatory requirements.

This position will be responsible for optimizing care management processes, fostering professional development, maintaining compliance, and improving member outcomes through data-driven decision-making and collaboration with internal and external partners.

JOB RESPONSIBILITIES

Leadership and Supervision

Provide positive leadership by establishing and reinforcing cultural values that support the Utilize Health mission.
Manage Care Management Supervisors and oversee the performance and development of Care Managers
Conduct performance evaluations, provide coaching, and foster professional growth opportunities.
Establish goals and performance standards in alignment with organizational objectives.
Promote a team culture focused on empathy, accountability, and excellence in member care.

Operational Oversight

Oversee day-to-day operations, including hiring, onboarding, scheduling, workflow, and administrative activities.
Design and maintain standardized onboarding processes, checklists and training plans to ensure a consistent, high-quality experience for all new team members.
Coordinate cross-functional onboarding activities (e.g., EMR access, required training, policy review) to ensure new hires are fully equipped to perform their roles.
Monitor new team members’ progress addressing barriers, providing feedback, and adjusting onboarding plans as needed
Oversee caseload management activities including audit reviews, utilization management and schedule coordination to ensure efficiency and quality of services.
Optimize resource allocation to ensure operational effectiveness and efficiency.
Develop, implement, and maintain policies and procedures that enhance member experience and drive positive outcomes.
Address member concerns and feedback in a timely, professional manner, conducting reviews and investigations as necessary.
Ensure accurate and confidential documentation in the EMR
Maintain compliance with federal, state, and local regulations as well as internal privacy and confidentiality policies, including HIPAA requirements.

Program Oversight and Quality Improvement

Ensure delivery of member-centered care by fostering interdisciplinary collaboration and prioritizing individualized care plans that enhance outcomes and experiences.
Collaborate with internal and external resources and healthcare providers to develop and implement programs and services tailored to member medical and social needs.
Monitor, measure, and evaluate program effectiveness using performance data and operational metrics.
Identify opportunities for program improvements and implement solutions based on data analysis.
Lead performance improvement initiatives to achieve service excellence, improved health outcomes and address social needs of members

Collaboration and Communication

Collaborate with VP, Clinical Operations and clinical team members to align care management with clinical best practices.
Partner with internal departments to ensure effective communication, process efficiency, and continuity of care management services
Build and maintain strong relationships with external providers, community organizations, and stakeholders across the service area
Serve as an ambassador for Utilize Health in representing care management initiatives and outcomes.

OTHER RESPONSIBILITIES:

Responsible for attending all in-services, continuing education, and annual health requirements.
Comply with all OSHA and safety policies, practices, and procedures. Report all unsafe practices or accidents to supervisor or compliance officer.
Will be compliant with the relevant regulations concerning the privacy and security of patient’s protected health information (PHI) as established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Perform other duties as assigned.

MINIMUM QUALIFICATIONS:

Bachelor’s degree in counseling, psychology, social work or health related field required. Master’s degree preferred.
Ability to travel throughout Tennessee as needed

EXPERIENCE

Minimum of five (5) years of experience in care management, case management, or related field
Minimum of two (2) years in leadership capacity managing multidisciplinary teams.
Experience with neurological or other complex medical populations preferred.
Experience leading programs that integrate behavioral health and physical healthcare coordination preferred.

JOB KNOWLEDGE, SKILLS AND ABILITIES

Passion for working with people with complex medical conditions and needs
Strong leadership and team-building skills.
Excellent organizational, analytical, communication and time management abilities.
Ability to interpret data to guide decision-making and performance improvement.
Knowledge of healthcare regulations, compliance, and confidentiality standards including HIPAA.
Proficiency in Microsoft Office Suite and electronic medical record (EMR) systems.
Demonstrated commitment to providing patient-centered, compassionate care.

APPLY

Please send cover letters and resumes to careers@utilizehealth.com.

Pre-employment screening required including background check and drug screening test. Utilize Health is a proud Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

Benefits:

401(k)
401(k) matching
Health insurance
Paid time off
Vision insurance

Work Location: Hybrid in Nashville, TN 37228

Apply now

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