RN Mgr, Care Management

apartment Summa Health location_onCleveland, OH, US

$41.15 - $61.72 / HOUR

RN Manager, Care Management

SummaCare - 1200 E Market St, Akron, OH

Full-Time / 40 Hours / Days

Hybrid

We are seeking an experienced (RN) Nurse Manager to lead our Care Management Team working with members and families with a variety of complex healthcare needs. Prior Care Management experience required. Previous health plan experience helpful. The role would be hybrid once acclimated, with one day a week onsite and occasional onsite for training or meetings.

Summary

Hybrid Home/Office presence needed to meet organizational, operational and service goals related to quality outcomes, member experience, and cost-efficiency. Plans, implements and manages Health Services Management activities for members needing a medium-to-high intensity of outreach and coordination, and a wide variety of supportive services in order to meet organizational goals related to quality outcomes, member experience and cost-efficiency.

Perform duties to conduct and manage the day-to-day operations of the care management functions. Communicate with staff to facilitate daily department functions including member/network navigation and population outcomes/goals for a variety of age groups and health care needs. Promotes coordination of members to clinically appropriate settings, and appropriate referrals to SummaCare programs.

Overtime during peak periods is possible. Rare need for weekend availability/support. Occasional travel to attend meetings, conferences, workshops, and/or seminars.

Formal Education Required

Registered Nurse (RN) state license in good standing required.
Bachelor’s Degree or equivalent combination of education and/or experience preferred
Case Management Certification (CCM, ACM) preferred

Experience And Training Required

Three (3) years performing care management/population management or like activities. Relevant experience includes: clinical nursing and health plan management, working knowledge of Medicare and/or Commercial plan designs, and experience with clinical regulatory and accrediting guidelines
Prior management/leadership experience
Moderate computer skills and familiarity with Outlook, Word, Excel, PowerPoint
Knowledge of Epic helpful
Knowledge of Interqual or MCG helpful
Other Skills, Competencies and Qualifications:
Ability to travel from location to location throughout the workday.
Knowledge of CMS, NCQA, a/o ODI requirements helpful for health plans.
Population Specific Competency: Ability to effectively interact with patients/customers with the understanding of their needs for self-respect and dignity
Level of Physical Demands:
Light: Exerts up to 20 pounds of force occasionally and/or up to ten pounds of force frequently, and/or a negligible amount of force continuously.

As a regional, provider-owned health plan, SummaCare values the relationship between the members and their doctors. SummaCare is a part of Summa Health, an integrated healthcare delivery system that includes Summa Health System hospitals, its community-based health centers, dedicated clinicians and SummaCare. Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.

Equal Opportunity Employer/Veterans/Disabled

$41.15/hr - $61.72/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.

Basic Life and Accidental Death & Dismemberment (AD&D)
Supplemental Life and AD&D
Dependent Life Insurance
Short-Term and Long-Term Disability
Accident Insurance, Hospital Indemnity, and Critical Illness
Retirement Savings Plan
Flexible Spending Accounts – Healthcare and Dependent Care
Employee Assistance Program (EAP)
Identity Theft Protection
Pet Insurance
Education Assistance
Daily Pay

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