Hybrid Manager I – Maternal, Child, and Women’s Health Care Management

at Elevance Health

• Job title: Manager I – Maternal, Child, and Women’s Health Care Management
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $90,960 - $163,728 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Woodland Hills, United States

About the role

• Manager I HCMS for Maternal, Child, and Women’s Health Care Management at Elevance Health. Responsible for managing a health care team to improve member services and outcomes.

Responsibilities

• Managing a team of physical and/or behavioral health practitioners responsible for coordinating member service, utilization, access, care management and/or concurrent review
• Ensuring compliance with global program elements as well as contractual or regulatory requirements
• Developing and implementing workflows and protocols in compliance with global programs and regulatory guidelines
• Assisting in identifying opportunities to improve operational efficiencies, clinical quality, and solution performance
• Analyzing solution specific reports identifying trends over time
• Coordinating service delivery to include member assessment of physical and psychological factors
• Partnering with providers to establish short and long-term goals that meet the members’ needs, functional abilities, and referral sources requirements
• Identifying members with potential for high-risk complications
• Reviewing benefit systems and cost benefit analysis
• Evaluating medical, mental health and substance abuse service for cost containment
• Supporting program compliance and assisting in identifying opportunities to improve the customer service and quality outcomes
• Supporting quality initiatives and activities, including adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting
• Hiring, training, coaching, counseling, and evaluating performance of direct reports

Requirements

• Requires BA/BS and minimum of 5 years of experience in Health Care Management
• Current active unrestricted RN and any other state or federal requirements that may apply is required
• MSN, MPH, MPA, MSW or MBA with Health Care Concentration preferred
• Prior bedside obstetric, pediatrics, and/or women's health experience is preferred
• Prior experience in Care Management
• Prior experience in managing or leading a team or project management is necessary to ensure exceptional attention to detail and an understanding of clinical operations is preferred
• Excellent written, oral, presentation, and interpersonal communication skills are strongly preferred
• Proficiency in Microsoft Office products—Excel, Teams, Outlook, PowerPoint, Word—and AI tools is strongly preferred
• Licensure in CA, NV, and/or WA is preferred

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• paid holidays
• Paid Time Off
• medical
• dental
• vision
• short and long term disability benefits
• wellness programs
• financial education resources