Top 4449 Program management Jobs in New Braunfels, Tx

TOP Case Management Program Manager
International SOS —San Antonio, TX
- Background check
- Nursing
- RN License
Quick Apply
Registered Nurse (RN) - Case Manager
Adaptive Home Health —Universal City, TX
- $60 per point
- Weekends as needed
- RN License
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
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Certified Registered Nurse Anesthetist
TSAOG Orthopedic & Spine —San Antonio, TX
- Full-time
- Spanish
- Nursing
- RN License
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Vice President of Engineering
Confidential —Universal City, TX
- $130,103.27 - $175,070.61 a year
- Full-time
- Background check
- Bachelor's degree
- Mentoring
- Relocation assistance
- Health insurance
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Certified Speech Language Pathologist
San Antonio —San Antonio, TX
- $60,000 - $85,000 a year
- Full-time
- CPR Certification
- BLS Certification
- HIPAA
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Professional/Executive Business Development Officer - New Braunfels
Moody Bank —New Braunfels, TX
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- Health insurance
- Dental insurance
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Clinical Services Manager - Respiratory Therapy
Sail Healthcare, LLC —San Antonio, TX
- From $75,000 a year
- Full-time
- Spanish
- Clean driving record
- Customer service
- Paid holidays
- Health insurance
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Hospice RN Case Manager – $85K–$91K | Mileage + Benefits
Guiding Light Hospice, Inc. —San Antonio, TX
- $85,000 - $91,000 a year
- Full-time
- Nursing
- RN License
- Hospital
- Wellness program
- Mileage reimbursement
Quick Apply
Utilization Review Compliance Analyst - NCQA/URAC (On-site)
Management Resources Group LLC (MRG) —Schertz, TX
- Full-time
- Microsoft Excel
- English
- Mid-level
- Health savings account
- AD&D insurance
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Certified Occupational Therapist
San Antonio —San Antonio, TX
- $70,000 - $85,000 a year
- Full-time
- CPR Certification
- BLS Certification
- Adults
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Registered Nurse (RN)/ Licensed Vocational Nurse (LVN)
MGA Homecare —Schertz, TX
- $23 - $41 an hour
- Part-time
- Mid-level
- Home Health
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
Psychological Associate II, LPC, LCSW, LMFT, MHA, Pos. #511, Corpus Christi, TX
Nueces County MHMR Community Center —Texas
- $65,229.36 a year
- Full-time
- LMFT
- Spanish
- Clean driving record
- Mileage reimbursement
- Loan repayment program
Nursing Director L&D
Resolute Health Hospital —New Braunfels, TX
- Full-time
- Background check
- Nursing
- RN License
- Health insurance
- 401(k)
Quick Apply
Occupational Therapist
ATI Physical Therapy —San Antonio, TX
- Part-time
- Mid-level
- Outpatient experience
- Clinic
- Continuing education credits
- Paid holidays
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Registered Nurse (RN)/ Licensed Vocational Nurse (LVN)
MGA Homecare —New Braunfels, TX
- $23 - $41 an hour
- Part-time
- Home Health
- Communication skills
- Entry level
- Health insurance
- Dental insurance
Quick Apply
Registered Dietitian (Work from home)
Kickoff —Texas
- $94,000 - $140,000 a year
- Choose your own hours
- Remote
- Mid-level
- 1 year
- Health insurance
- Work from home
Quick Apply
Production Control Business Leader
CFAN Company —San Marcos, TX
- $80,000 - $120,000 a year
- Overtime
- Background check
- ERP systems
- Mid-level
- Disability insurance
- Health insurance
Quick Apply
CNC Programmer/Operator - ADA Specialist
NAI Signs —Schertz, TX
- Full-time
- Background check
- Mid-level
- Organizational skills
- Health savings account
- Paid holidays
Quick Apply
Therapist
Upbring —Canyon Lake, TX
- Full-time
- LMFT
- Licensed Clinical Social Worker
- LPC
- Paid holidays
- Health insurance
Tax Manager
The Fox Alliance Tax Advisors —San Antonio, TX
- $135,000 - $150,000 a year
- Email
- Hybrid work
- Background check
- Spanish
- CPA
- Paid parental leave
- AD&D insurance
Quick Apply

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TOP Case Management Program Manager

International SOS -
San Antonio, TX

Quick Apply

Job Details

Qualifications

RN License
Medical treatment knowledge
Customer engagement
Productivity software
Certified Case Manager

Full Job Description

Essential Job Duties and Responsibilities:

At International SOS, we are in the business of protecting and saving lives. For 40 years, we have delivered customised security risk management, health, and wellbeing solutions to organisations worldwide. With a presence in 90 countries and a team of nearly 13,000 experts, we provide 24/7 support to help organisations fulfil their Duty of Care responsibilities.

Now, we’re looking for talented individuals to join our team and make a difference.

Case Management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual’s and family’s comprehensive health care needs through collaboration and communication regarding available resources to promote high quality, cost-effective outcomes.

The TOP Case Management Program Manager is an integral member of the TRICARE global Medical Team. The individual is responsible for managing the TOP Case Management Program to identify and support the management of the health care of individuals with high-cost conditions or with specific diseases or conditions for which evidence-based clinical management guidelines exist.

The TOP Case Management Program (CMP) is delivered by the Program Manager and their three direct reports, the Case Managers for each TOP region. This may be done telephonically and/or face to face to assess, plan, implement and coordinate all case management activities with TRICARE beneficiaries eligible for the TOP Case Management Program.

The core and critical responsibilities of the role includes:

To work collaboratively with superiors, peers, and other individuals in the completion of duties – both internal to International SOS as well as with subcontractors, the Defense Health Agency, and the TRICARE beneficiaries we serve.
Ensure a high level of professionalism at all times when dealing with beneficiaries, colleagues, and TRICARE.
Ability to work within a remote team to actively drive a high level of service delivery.
To apply medical knowledge to high cost, unusual or complex requests for medical care to determine medical necessity and appropriateness.
Demonstrate written and oral communication skills to formulate business correspondence and convey complex medical information to other key stakeholders.
Maintain an overview of any challenging or complaint cases and provide direction as required / requested.

Management of the TOP CMP:

Establish, develop, standardize, and maintain quality of the TOP CMP.
Review all referred cases from any source and provide determination regarding appropriateness of inclusion in the TOP CMP.
The allocation of new cases to the designated case managers for engagement and case management.
Monitor the case managers’ case assignment and workload distribution.
Hold regular meetings with the CMNs to facilitate case discussion, provide support and guidance and deliver ad hoc role specific training.
Ensure TOP CMP cases are appropriately managed and provide case direction as required.
Promote and reinforce the need for evidence-based medical decision making.
For OCONUS TRICARE Prime ADSM/ADFMs enrolled to an MTF, notify the MTF that the beneficiary has a qualifying diagnosis for case management by the MTF.
Review and document case/cost savings due to the TOP CMP.
Work collaboratively with other business functions such as the Operations, Beneficiary Support Centre (BSC), Utilization Management, TPSS / WPS regarding identified billing and claims issues that TOP CMP beneficiaries are experiencing.

Description:

Education:

Provide TOP CMP induction and ongoing role specific education, support, coaching and direction to the CMNs.
Provide TOP CMP education to other key stakeholders on an ad hoc / as required basis, i.e., Operations, TPSS etc.

Client Interaction:

Act as a subject matter expert regarding the TOP CMP
Maintain a high level of client and procedural knowledge and ability to engage and interface with the client where appropriate.
Participate in monthly TOP CMP case presentations to the TRICARE Area Office Medical Director/s and Nurses.
To present and participate in semi-annual surveillance audits.
To participate in any other client related duties as required.

Reporting:

Tracking and trending of TRICARE beneficiaries who accept case management services, length of time on case management, diagnoses of members on case management, readmission of individuals case managed, projected cost savings resulting from case management, and other metrics as determined by contract or internal stakeholders.
Create and maintain dashboards within the CRM case management system to support the aboveOperations
Responsible for the tracking, trending, and reporting of TOP CMP cases and quality improvement initiatives for the annual CDRL A110 - Clinical Quality Management Program Clinical Quality Oversight Report Plan Report.
Act as the lead, in collaboration with the TOP Data Analytics team and CQAIL for the accurate and timely submission of the CDRL M010 – Monthly Case Management Report
Support the completion and review of the annual CDRL – P050 Case Management Program Plan.
Assist when required with the preparation and/or presentation of other ad hoc reporting regarding the TOP CMP i.e., for semi-annual audits etc.
Act as the subject matter expert for the creation, review, and revision of Standard Operating Procedures (SOPs) assigned to the Case Management Program.

Quality:

Focus on quality-of-service delivery to ensure that the highest possible levels are achieved.
Report to the TOP DoN the program progress, quality concerns and any other areas of concern and submit feedback to the International SOS customer feedback system as needed.
Conduct internal and semi-annual surveillance audits of the TOP CMP for monitoring of performance, trend analysis, etc.
Manage complaints in a professional manner, resolving them wherever possible or escalating them to the appropriate department.

Other Duties:

Work within a team and promote all International SOS & TRICARE policies and procedures.
Any other duties allocated by the TOP Director of Nursing and/or the TOP Head of Clinical Operations and Policy
To work flexible hours as appropriate to the needs of the post.
To recognise limitations and areas of self-development through reflection. To be responsible for all actions and decisions made, knowing when to defer or escalate to other senior members of the quality and medical teams.
Keeps own operational technical / functional skills and knowledge up to date.
Be responsible for own Continuing Professional Education. International SOS will endeavour to support appropriate Continuing Professional Education requests.
Attend supervision, training, and departmental meetings as and when required.
Undertake accountability for workload.
To keep accurate records.

Required Skills and Knowledge (Brief description of technical knowledge or skills needed to perform the job)

Attention to detail.
Broad Medical Knowledge.
Effective communication skills: Exercise’s discretion and judgment when providing feedback, guidance, and clarification to ensure the relationship is protected.
Converses fluently in English.
Ability to provide clear and concise written updates in English.
Identifies and acts on potential problems and / or difficulties.
Demonstrates appropriate listening skills.
Demonstrates effective problem-solving skills and lateral thinking.
Able to work under pressure and to prepare accurate and timely reports in line with the requirements of the TOP.
Working knowledge of Microsoft Office applications and the ability to learn and work with International SOS and subcontractor databases and software.
Knowledge or familiarity with the TRICARE Overseas Program (preferred).
Positive motivation, encouragement, and influence skills

Required Competencies (Critical behaviors necessary to successfully perform the job)

Customer service oriented.
Empathetic and able to positively influence the customer journey experience.
Team player.
Has initiative, takes responsibility.
Ability to work independently.

Required Qualifications (Brief description of the educational background needed to perform the job)

3+ years clinical experience required.
US RN licensure required.
Nursing education qualification with maintained governance appropriate to country / body of qualification
Case Management certification by recognised US body
Managed care experience preferred.
TRICARE experience preferred.

Required Languages (Brief description of the language skills needed to perform the job)

Excellent spoken and written English. Additional language skills (particularly Spanish) are desirable, but not essential

Travel / Rotation Requirements (Brief description of any travel or rotation requirements)

Flexible hours as appropriate to the needs of the post.
Ability to travel locally and internationally if required to support client and business functions preferred.

Work Location: In person

Quick Apply

Refine Your Search

program management jobs in new braunfels, tx

TOP Case Management Program Manager

Registered Nurse (RN) - Case Manager

Certified Registered Nurse Anesthetist

Vice President of Engineering

Certified Speech Language Pathologist

Professional/Executive Business Development Officer - New Braunfels

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Hospice RN Case Manager – $85K–$91K | Mileage + Benefits

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Certified Occupational Therapist

Registered Nurse (RN)/ Licensed Vocational Nurse (LVN)

Psychological Associate II, LPC, LCSW, LMFT, MHA, Pos. #511, Corpus Christi, TX

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Occupational Therapist

Registered Nurse (RN)/ Licensed Vocational Nurse (LVN)

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Therapist

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I want to receive the latest job alert for program management in new braunfels, tx

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