Search | Care Management Director

Are you a “roll up your sleeves and get it done” kind of leader?

An innovative, strategic and high impact Care Management Director can join one of the largest health care organizations in the US. Based in the mid-west, our client has been serving the Medicaid population for decades. They continue to be recognized as an innovator and one of the most admired companies in their state.

Listed as one the top places to work, employees enjoy a full range of comprehensive benefits, competitive salaries and bonuses, as well as community involvement and diversity. The company’s continued leadership in Medicaid creates significant opportunities for career advancement and personal and professional growth.

The High Risk Care Management Director will be the primary representative of the company in their city.   As the leader of this new program, the first responsibility is to further develop and implement the program. This includes creating partnerships with community based resources, presenting to organizations, and working with the Manager and field staff on a regular basis. In addition to program development, the Director will create and oversee a new staff development program. This will involve team and individual training across a wide variety of staff positions. Both the staff and program development responsibilities will result in this high risk care management program becoming the model for the industry. Additionally, the Director will also use their strategic and problem solving skills to assist the Vice President in special projects.

Care Management Directors with strong experience in program development are the first choice for this position. Expertise in care management protocols , experience in staff development, and experience in project management are equally prized by our client. This position is open to an RN, MSW, Clinical Counselor, or licensed Psychologist. Advanced business degrees or experience is also a plus.

Apply now to be considered. This kind of high-profile, career building position does not stay open very long!

Click Here to Contact Us

Case Manager |RN |IL |Search

Medicaid Case Manager RN

Medicaid Case Manager RN

Join an organization that TRULY values their nurses! This is a rare opportunity for an RN with experience in UR to step into a managed care setting with plenty of room for growth. Review inpatient admissions to assure appropriate level of care and medical necessity. This will be done on site and tele phonically. Audit patient charts through on-site hospital visits, act as clinical resource to referral staff and make appropriate referrals. Educate patients and providers. Enters assessments, authorizations and reviews into the system.

Position requires an RN with min. 2 yrs clinical exp and UR exp. Current state nursing and driver’s license.

Knowledge/Experience: At least two years clinical nursing experience.


Enrollment Assistance

Medicaid-Enrollment-Managed-Medicaid-ServicesThe timely and accurate enrollment of Medicaid members is crucial for Medicaid Managed Care Organizations. Contractual obligations, state regulations, service requirements, and financial considerations are issues impacted by the enrollment process. Large member increases or entering new states will also impact the enrollment process.

Enrollment Assistance

It takes trained, experienced people on the ground to facilitate enrollments, answer questions, find eligible members or coordinate the process. Managed Medicaid Services has the experience, network, and resources to quickly assemble an enrollment team and get the process started. This allows Medicaid health plans to meet implementation deadlines and more competitively price their RFPs.

Need enrollment help? Contact us for a complimentary consultation about this valuable service.

Medicaid Assessments

Medicaid-Assessment-Managed-Medicaid-ServicesIn almost every version of Health Care Reform legislation there is a Medicaid expansion provision. This expansion will create rapid enrollment increases leaving companies with little time to prepare. Most state governors also support increasing HBCS program participation. With a waiting list for these services that has grown by more than 31% in the past several years, there is a tremendous demand for these programs.

Medicaid Assessments

Medicaid managed care companies, especially those with at-risk health plans, will need to respond quickly and accurately to the needs of their new members. They seek cost effective ways to assess members when they move into new states. One of the best ways to do this is to have a network of clinical professionals who can respond to this need. Nurses and Social Workers who are trained and experienced in Medicaid home assessments are needed quickly to complete assessments within the state mandated guidelines.

Managed Medicaid Services has been providing this service to Medicaid Managed Care companies for over two years. Having completed more than 6000 in home assessments, we understand the process and the need for accurate and timely visits to eligible members.

To learn more about how this service can reduce your costs and respond rapidly to your needs contact us today.

MMS Case Manager Network

Medicaid-Case-Management-Managed-Medicaid-ServicesWhen you need to quickly and efficiently ramp up your Medicaid care management or care coordination services, the is the first place to turn. Our network of professional and qualified case managers can be available on short notice for long-term or short-term projects to assist you with:

  • Quickly implementing new plan operations
  • Handle rapid enrollment expansion
  • Overflow case work
  • Easily budgeting staffing costs for RFPs
  • Quick Implementation – we can be ready within 48 hours to support your Medicaid assessment, ongoing case management, or new enrollee needs.

MMS Case Manager Network

Network – Our network of experienced case managers (RNs and SWs) can take on a variety of case loads in diverse geographical location. We can hire and train our team in a very short time.

Experience & Knowledge – Having completed more than 6000 Medicaid assessments and currently working hundreds of ongoing care management cases, we can adapt and quickly implement a workflow specific to your product’s requirement.

New Enrollee Assistance – Our staff can help you meet state regulations for new enrollee’s, reducing your need for additional FTE’s and impacting current staff workloads.

Ongoing Case Management – The experienced case managers in our network are available if your case loads are too high, if your patient volume fluctuates, you need coverage in areas that don’t justify new FT staff, or if you need to quickly ramp up for a new plan.

Clinical Supervision – The team assigned to your cases or assessments will be supervised by an experienced and credentialed RN familiar with Medicaid and care management.

Training Support – Through our experience we can conduct training for new staff on your requirements so you don’t have to allocate your own FT resources to train our team.

The MMS Case Management Network is a cost effective and efficient solution for many Medicaid MCOs. Please contact us to see if it is the right solution for you.