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: |
| Name | Level | Experience | Required |
| Case Management | | | No |
| Clinical Documentation | | | No |
| Clinical Resource Management | | | No |
| Management Experience | | | No |
| Utilization Review | | | No |
|
| 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:
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
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.
|
