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…