Care Management Cover Letter

Please consider me for the care management opportunity. I am including my resume that lists my qualifications and experience.

In my previous role, I was responsible for leadership in management of utilization management and medical management and is the executive medical director that represents the company in these initiatives internally and externally.

Please consider my qualifications and experience:

• Create, review and evaluatie care plans on an ongoing basis through member, family, health partner and stakeholder contact
• Identify appropriate resources to address member’s psychosocial, financial and other needs related to healthcare
• Contribute to team coordination and member outcomes
• Maintain current and accurate documentation within the Care Management electronic record
• Act as a liaison to social services/community resources and government agencies
• Assist in in ensuring that resources are accurate and up to date
• Participate in meetings with health partners to inform them of Care Management services and benefits available to members
• Knowledgeable of local, state and federal resources

I would like to submit my application for the care management opening. Please accept this letter and the attached resume.

In the previous role, I was responsible for managed care consulting support to clients including areas such as healthcare insurance solutions, innovative product development, medical trends, network consulting and contracting, medical management programs, pharmaceutical management, and medical operations.

Please consider my qualifications and experience:

• Proficient in use of Milliman Criteria and other guidelines for medical necessity and appropriate level of care
• Bachelors in Nursing or Social Work
• Previous experience in Care Management or Utilization Management
• Able to independently address routine situations utilizing knowledge, experience and established resources including department policies and procedures
• To transfer information from paper to computer, from computer to computer, and to communicate in person and on the telephone
• Able to work under deadlines and in fast paced environment
• Able to prioritize independently and respond to multiple, simultaneous requests
• Able to maintain patient privacy and confidentiality

I am excited to be applying for the position of care management. Please accept this letter and the attached resume as my interest in this position.

Previously, I was responsible for oversight for the medical necessity reviews, denials management, and utilization management supporting all areas of the organization within the assigned region.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Serve as resource and provide updates on social services for care management team
• Provide assistance with mentoring new staff
• Educational preparation in social work and/or nursing
• Demonstrated experience and success in implementing and managing organizational processes involving case and disease management, medical management, physician engagement and education, and financial review of total cost of care
• Experience in leveraging information technology for clinical and operational improvement
• Current recognition by a national professional organization in utilization management, case management or quality improvement
• Compliance with all regulatory agency requirements is essential as consequences could result in potential for sanctions up to possible contract termination for all product lines
• Experience in successfully working with payors regarding care transitions, payment and reimbursement creative approaches to meeting patient needs with available resources

I am excited to be applying for the position of care management. Please accept this letter and the attached resume as my interest in this position.

In my previous role, I was responsible for consultative resources and advice to District management and employees in all areas of absence management and leave administration consistent with federal and state disability laws, District policy and labor agreements.

My experience is an excellent fit for the list of requirements in this job:

• Experience as a senior manager and people leader in the Healthcare/Managed Care industry
• Demonstrated strategic thinking, process improvement, innovative thinking and team management expertise
• Demonstrated experience in the usage of data to guide decision making
• Experience in Health Plan or Provider-based Care Management, preferably with Medicaid and Medicare eligible populations in the New York area
• Familiar with Population Health Management
• Experience leading care management teams
• Strong working knowledge of Microsoft products including Excel and PPT
• Knowledge of Federal and State regulations, third party payers/managed care principles

In response to your job posting for care management, I am including this letter and my resume for your review.

Previously, I was responsible for regular reports/updates on technology trends to management on the prevalence, utilization, effectiveness and implementation of new technology.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Current State of Washington RN license
• Knowledge of the healthcare financial environment, reimbursement and levels of care
• Maturity and interpersonal skills necessary to lead and coordinate an interdisciplinary team and deal effectively with patients and families from a variety of backgrounds and with varied emotional and medical needs
• Age-appropriate developmental assessment skills
• Oral and written language skills
• Learns quickly and is able to mine useful information and data from multiple sources
• Comfortable taking measured risks
• Can quickly focus in on the mission-critical agenda