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Manager of Case Management

Location:Greensboro or Charlotte , NC
Salary Range:Competitive
Employment Type:Full Time
Department:Managed Care
Description:  Manager of Managed Care

Key Risk, a division of Berkley Insurance Company, a leading provider of workers compensation insurance products and services for employers throughout the Eastern United States, is accepting applications for a Manager of Case Management located in the Greensboro  office. A successful candidate will be responsible for maximizing the effectiveness and efficiency of managed care solutions in areas of medical case management and maximizing successful outcomes on claims files.   He / she will also be responsible for professional and administrative staff within the Managed Care Department.


Duties:  A.        Financial

1.         Plan financial goals and objectives for Managed Care

2.         Manage budgets for all MC departments

3.         Calculate fee proposals based upon validated loss information

4.         Achieve all projected revenue, profit and expense goals

5.         Contribute to all strategic, financial and growth goals of the corporation   


B.         Cost Containment Services

1.         Direct all aspects of utilization review.

2.         Work closely with Director of Cost Containment to ensure effective integration of utilization review interventions with medical bill review adjudication

3.         Analyze all management reports and data to insure workflow efficiency and targets are being achieved.

4.         Implement strategies to improve outcomes, penetration and cost savings

5.         Insure all professional staff at Key Risk is effectively trained in utilizing cost containment solutions.


C.         Case Management

1.         Insure all quality assurance procedures are followed

2.         Evaluate the effectiveness of all workflow, supervisory procedures, training and orientation process          

3.         Direct all recruitment, interviewing and hire decisions to promote effective achievement of all department initiatives and goals

4.         Analyze all management reports and data to insure workflow efficiency and targets are being achieved.

5.         Implement strategies to improve outcomes and increase revenue

6.         Insure all professional staff at Key Risk is effectively trained in utilizing cost containment solutions.


D.        Strategic Planning

1.         Analyze all aspects of outcome achievement, penetration and cost savings to determine strategies to improve performance in these areas                    

2.         Plan and execute strategies to improve cost containment and network penetration

3.         Develop senior management reports of performance as well as actions planned


E.         Leadership


1.             Provide continuous nurturing and empowerment of all staff to promote their critical  thinking and performance

2.         Direct regular, meaningful team and staff meetings for both supervisors and staff to insure all staff understand and take ownership of goals and objectives

3.         Provide leadership development to Directors, Managers, and Supervisors within the Managed Care Department.

4.         Demonstrate strong leadership skills through serving on various corporate committees





A.        Degree in Rehabilitation or Nursing Administration or equivalent educational levels appropriate to this position (CRC, CRRN, MA, BSN, MSN)

B.         Minimum 5 years of experience in mid-level management of managed care delivery systems

C.         Ability to effectively lead staff to successful outcomes and achievements

D.        Ability to develop and present proposals including pricing analysis and negotiations

E.         Ability to think strategically and implement project plans effectively to reach established goals

F.         Ability to effectively summarize performance in management reports in order to evaluate effectiveness of services and make improvement recommendations to senior management.

G.         Working knowledge of all business software including MS Word, Excel, Project as well as specific case management and medical bill adjudication software.




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