59 Best remote rn Jobs in Sterling Heights, Michigan (October 2025)

Oakland Community Health Network

Integrated Healthcare-Care Manager

1 month ago

Troy

Job Description HYBRID SCHEDULE, NO NIGHTS, NO WEEKENDS, NO HOLIDAYS The Integrated Healthcare-Care Manager provides coordination of healthcare services, benefits, and resources to align with OCHNs integrated healthcare initiatives. The Integrated Health Care Manager collaborates with providers and individuals served to assess, plan, implement, coordinate, monitor and evaluate options and services to meet individuals’ health needs through available resources to promote quality and cost-effective outcomes. Additionally, the Integrated Health Care Manager provides content expertise related to integrated healthcare to the OCHN provider network and to support OCHN in adhering to regulatory requirements and maintaining accreditation. Essential Functions Under direction: • Work with a multi-disciplinary team to establish shared care plans and coordinate care through the health care continuum., • Research and resolve issues related to benefits, services, coordination of benefits, and Mental Health and Substance Abuse care coordination., • Actively promote communication between individuals served, family, providers, Medicaid Health Plan, and healthcare providers., • Identify, document, and resolve quality of care issues., • Promote and engage in positive and constructive daily teamwork., • Conduct screening and assessments as needed, • Utilizes population health and other healthcare information to refer individuals to targeted health and wellness services., • Makes referrals for individuals deemed “high-risk” and /or “at risk” to receive appropriate medical and behavioral health services., • Utilize multiple applications to access and organize data for analyses to guide population health management activities., • Analyze data and management reports for ongoing quality assurance efforts, • Participate in workgroups and committees with OCHN, Medicaid Health Plans, and provider organizations., • Complete all documentation in accordance with Medicaid and NCQA regulations. Education: • Bachelor's Degree in nursing, allied health, business, or related field preferred., • State of Michigan license, certification and / or registration as Psychologist (LLP, LP), Social Worker (LMSW), Counselor (LPC), or Marriage and Family Therapist (LMFT) or Registered Nurse (RN), • For children’s services - maintain/attain 24 hours annually of child-specific training (Child Diagnostic and Treatment Professional)., • At least three years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc., • Relevant experience in providing services to Individual’s with Intellectual / Developmental Disabilities or Adults with Mental Illness and/or persons with substance use / co- occurring disorders and/or experience with Children with Serious Emotional Disturbance preferred, • Knowledge of the Michigan Mental Health Code., • Understanding of Medicaid rules and regulations., • Knowledge of NCQA strongly preferred., • Understanding of case management and care coordination., • Understanding of managed care philosophy, policies, and procedures., • Understanding of use of clinical guidelines and criteria for medical necessity, setting/level of care., • Understanding of population health management components and strategies., • Knowledge of medical terminology and ICD10 and DSM5 diagnoses., • Knowledge of State and Federal HMO regulations., • Leadership style that is team driven, open, accessible, and transparent., • Excellent customer service and interpersonal skills, including the ability to interact with internal and external customers at all levels of organizations., • Excellent written and verbal communication skills., • Excellent documentation skills., • Ability to use multiple applications to access data for analysis., • Ability to develop and implement interventions to improve health outcomes for individuals based on analyses of population-level., • Strong problem-solving, analytical, and decision-making skills., • Strong organizational, planning, and implementation skills., • Ability to manage multiple projects and timelines., • Ability to effectively present information both orally and written to administration, the public and/or Board of Directors., • Maintains confidentiality and compliance standards., • Flexible., • Cultural competency expertise and orientation., • Interacting with others in a way that gives them confidence in one’s intentions and those of the organization; demonstrating loyalty to the organization and its mission and values; maintaining social, ethical, and organizational norms; firmly adhering to codes of conduct and ethical principles. (Integrity/Building Trust), • Making customers and their needs a primary focus of one’s actions; developing and sustaining productive customer relationships, recognizing that the ultimate customer is the person served. (Customer Focus), • Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application. (Continuous Learning), • Setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks; self-imposing standards of excellence in addition to consciously adopting organizational standards of excellence. (Work Standards) (Travel required, physical requirements, etc.): • Must have available means of transportation to and from OCHN and for required offsite meetings or site visits., • Work performed primarily in an office environment., • Hybrid (onsite/remote) work schedule available.

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