About Fallon Health
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.
Responsible for the management of Fallon Health’s care management programs including chronic care management (disease management), complex case management, care management and care coordination. The Manager will work closely with the Manager of Health Promotions, the Director of Care Management, a physician champion and the VP of Quality and Clinical Operations to create a seamless structure and consistent suite of program services between the various member ‘risk levels’.
The manager will ensure timely coordination of quality healthcare services for; and supervise support and assist in the development, continuous improvement and implementation of the Care Management Program. The Manager of Care Management is responsible for all of the activities related to:
Graduate from an accredited school of nursing or a Bachelors (or advanced) degree in nursing or a health care related field.
Registered Nurse in Massachusetts; current Massachusetts driver’s license. or a Social Worker (LICSW, LCSW or CSW)
A minimum of three to five years as a case manager, preferably within the health plan environment, knowledge of government and accreditation requirements, or experience as a manager in the health plan environment in the clinical areas