Manager Case and Disease Mgmt

Job Summary - Manager Case and Disease Mgmt

Provides supervision and leadership to the team of Priority Health Case Managers and support staff ensuring department goals and standards are met. Accountable for daily coordination of case/disease/UM functions. Responsible for the operations and acts as a resource and consultant to the team. Provides oversight of processes and procedures to assure that the individual's specific health needs are met to promote the highest quality of care in the most appropriate setting.

Essential Functions - Manager Case and Disease Mgmt

• Oversee, supervise, and manage daily operations including hiring, training, coaching, and performance evaluation to ensure productivity and quality outcomes.
• Develop and implement training modules to support staff competency and program effectiveness, while fostering continuous improvement and professional growth.
• Collaborate with leadership to assess departmental needs, research and design new health management programs, and oversee implementation and post-launch monitoring.
• Review policies and procedures, and ensure compliance with regulatory and accrediting standards, while promoting best practices aligned with Priority Health’s value proposition.
• Ensure seamless integration of Case Management, Disease Management, and Utilization Management (as applicable) functions across departments, identifying and resolving service barriers.
• Develop measurable outcomes, monitor program impact on member health, and collaborate with other managers to implement performance monitoring and improvement plans.
• Serve as a resource for internal and external stakeholders, participate in presentations, and support communication efforts with providers, employers, and members.
• Support budget planning and management, operate within defined financial parameters, and utilize internal and community resources effectively to meet departmental goals.

Qualifications - Manager Case and Disease Mgmt

• • Required Bachelor's Degree or equivalent in health-related field
  • Preferred Master's Degree for those who do not have MSW, MA or MS degree
  • 5 years of relevant experience clinical experience in health services setting Required
  • 3 years of relevant experience managed care and/or case management experience Preferred
  • Strong knowledge of management health care Preferred
  • Knowledgeable on compliance and regulations as it relates to Case Management Programs Preferred
  • LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire preferred Or
  • LIC-Master Social Worker (MSW-Master) - STATE_MI State of Michigan Upon Hire preferred
  • CRT-Case Manager, Certified (CCM) - CCMC Commission for Case Manager Certification preferred

Physical Demands - Manager Case and Disease Mgmt

• Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
• Waist to Waist > 5 lbs: Seldom up to 10 lbs
• Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
• Waist to Overhead > 5 lbs: Seldom up to 10 lbs
• Bilateral Carry > 5 lbs: Seldom up to 10 lbs
• Unilateral Carry > 5 lbs: Seldom up to 10 lbs
• Pushing Force > 5 lbs: Seldom up to 10 lbs
• Pulling Force > 5 lbs: Seldom up to 10 lbs
• Sitting: Frequently
• Standing: Occasionally
• Walking: Occasionally
• Forward Bend - Standing: Seldom
• Forward Bend - Sitting: Occasionally
• Trunk Rotation - Standing: Seldom
• Trunk Rotation - Sitting: Occasionally
• Reach - Above Shoulder: Seldom
• Reach - at Shoulder or Below: Seldom
• Handling: Occasionally
• Forceful Grip > 5 lbs: Seldom
• Forceful Pinch > 2 lbs: Seldom
• Finger/Hand Dexterity: Frequently

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - 2503 North Hillcrest Parkway - Altoona

Department Name

Group Health Cooperative of Eau Claire - PH Managed Benefits

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8:00 a.m. to 5:00 p.m.

Days Worked

Monday through Friday

Weekend Frequency

N/A

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.