Sunday, March 10, 2019

HOT!!! Manager, Case Management

Please send resumes to HWatts@TheClinicalRecruiter.com or click HERE to apply online!
Posted Date:3/8/2019
Job Category:Case Management
Position Title:Manager, Case Management
Salary Range:BOE
Location:Saginaw-Bay City-Midland, Michigan, USA
Desired Skills:
NameLevelExperienceRequired
Case ManagementNo
Clinical DocumentationNo
Clinical Resource ManagementNo
Management ExperienceNo
Utilization ReviewNo
Description:
Manager of Case Management
Bay City / Saginaw / Midland, MI

Now Hiring a Manager of Case Management for a 500+ bed facility in Michigan! Great advancement opportunity for a Case Manager who has some acute care nursing supervisory experience and is ready for the next step! Please send resumes to Hwatts@theclinicalrecruiter.com for more details.

General Summary:
  • The Manager of Case Management assumes 24-hour responsibility and assists with the direction, management, and evaluation of the Case Management/Social Work departments.
  • Reports to the Director of Case Management and assists with clinical, operational, and financial aspects of the Case Management/Social Work departments.
  • Manages all aspects of Case Management and Utilization Management, including admission and continued stay medical necessity reviews, payer authorization, discharge planning, denials management, and ensures adherence to the case management plan.
  • Assists with hiring, training, directing, development and evaluating of staff.
  • Assists with development of action plans, and may report outcomes to the Case Management Director, CNO, or others as applicable.
  • Assists with the design, implementation, training, and resources for the Case Management system for the organization.
  • Evaluates personnel, assesses environment, and determines priorities for care in order to plan, implement, and evaluate outcomes of care.  
  • Evaluates the effectiveness of existing clinical protocols and pathways and makes recommendations for new ones.
  • Works effectively with MCO staff and leadership to decrease denials or downgrades in reimbursement.
  • Ensures collaboration among health care providers across the Continuum of Care to maximize effective access and efficient utilization of resources.

Experience:  
  • 3+ years Case Management experience required
  • 2+ years nursing supervisory/management experience in acute care required
  • Managed Care Organization (MCO) experience preferred

Education:
  • Bachelor of Science in Nursing (BSN) required
  • Master’s Degree in Nursing or related preferred

Certifications/Licensures:
  • Registered Nurse License required
  • Certified Case Manager (CCM) highly desired
  • Healthcare Quality of Utilization Review (HQUR) a plus

Special Skills:  
  • Must be able to use independent decision-making skills in a wide variety of situations
  • Frequent contact with employees, physicians, customers, community individuals and volunteers
  • Must be self-motivated to complete work in a timely manner to meet deadlines
  • Experience with Core Measures, Quality Indicators, Case Management, and Utilization
  • Knowledge base of InterQual criteria
  • Knowledge of Managed care trends, Medicare, and Medicaid regulations
  • Advanced negotiation and mediation skills


Please send Resume to HWatts@theclinicalrecruiter.com for additional information about this position.

Case Management Recruiter is a niche division of The Clinical Recruiter focusing exclusively on Nursing Leaders in the Case Management specialty. Please visit www.casemanagementrecruiter.com for more details.  

The Clinical Recruiter, a nation-wide healthcare placement firm, was founded with the goal of bringing qualified healthcare professionals together in order to create an optimal atmosphere for great patient care.  Please visit our website for additional information at www.theclinicalrecruiter.com.

If you would like to learn more about this opening, please contact me at your earliest convenience.  If this is not something you are interested in, but you know of someone who would be a good fit, I would appreciate the referral.  Thanks!

Heather Watts
Case Management Recruiter



Keywords: Case Management, Manager Case Management, Case Manager, Care Manager, Care Management, Utilization Review, Director Case Management, Director of Care Management, Director Utilization Review, Director Care Coordination, Director Clinical Resource Management, Utilization Nurse, Clinical Documentation Specialist, Clinical Resource Management, Nurse Manager Utilization, Nurse Case Management.

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