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Staff VP Case Management (Clinical) - Cerritos, CA pref. or other CareMore offices (PS21220)Location: Cerritos, California, United StatesNewRequisition #: PS21220What Is CareMore?CareMore is entering a new growth phase, as a
proven care delivery model for the highest-risk. We are a team of
committed clinicians and business leaders passionate about transforming
American healthcare delivery. We build and lead integrated, multi-disciplinary
clinical teams to care for the most complex patients and currently serve nearly200,000 patients in multiple states across Medicare, Medicaid, and
commercial populations. We strive for excellence and have achieved
significant and measurable improvement in total cost of care, clinical
outcomes, and experience. As an Anthem subsidiary, we benefit from the
scale and resources one of America’s largest managed healthcare organizations.CareMore’s Health Networks, Primary Care+,Touch and CareMore@Home models drive strategy, operations, and care
delivery in our national markets (Arizona, California, Colorado, Connecticut,
Iowa, Nevada, New York, Tennessee, Texas, Virginia and the District of
Columbia), where CareMore builds and runs capitated primary care medical
groups, at-risk health networks and upstream care delivery products in service
of high-risk Medicaid, Medicare and commercial patients, and ourcollaboration with Emory Health System in Georgia . Our comprehensive, upstream approach to health is led by robust multidisciplinary teams of extensivists (managing acute and post-acute episodes of care), primary care
clinicians, behavioral health clinicians, care management & engagement
specialists (including social workers, case managers and community health
workers), and mobile home-based care teams. We continue to evolve our model to
effectively engage and care for complex patients, led by a team of
passionate, execution-minded leaders dedicated to this mission.For more information, visitResponsible for integrated care management services for CareMore multi-state and multi-payer markets.Primary duties may include, but are not limited to:
Manages care management delivery teams which may include, Case Management/Disease Management, Transitions of Care and clinical programs.
Delivers quality, high touch, customer responsive, and cost effective care.
Leads care delivery teams providing integrated solutions including behavioral health, wellness, Population Health, and provider partnerships. Manages medical loss ratio. Partners with other CareMore Clinical Programs, Payer Clients, and state leadership to deliver market leading care management services, root cause analyses and solutions to achieve engagement and quality outcomes.
Develops and manages communications on CareMore Care Management issues and opportunities.
Develops and implements process redesign and programmatic improvements. Serves on internal and external quality and provider committees.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requires a BA/BS, RN preferred ; 10 years of experience in managed care/health care environment or related field, including 4 years of management experience; or any combination of education and experience, which would provide an equivalent background.Please note this location can be based in any of CareMore offices listed below:Preferred Location:Cerritos, CAOther Locations:Tucson, AZSanta Clara/San Jose, CADenver, COHartford, CTWashington DCDes Moines, IACharlotte, NCLas Vegas, NVMemphis, TNFort Worth, TXRichmond, VAAnthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
