Responsible for the day to day operations of case management, social services and discharge planning functions. Serves as the subject matter expert for utilization management and regulatory compliance for the director and department members. Accepts multiple management tasks to handle financial, operational, managed care and staffing issues within the CIC Department. Assists in transitioning employees to a new era of practice management and risk sharing in the changing regulatory and managed care market. Teaches employees the rules for playing on an expanded team which consists of both internal and external case managers in order to meet regulatory guidelines and maintain or obtain managed care contracts. Proactively develops and promotes methodologies that effect staff productivity. Creates "risk free" environment for employees that encourage creativity and productivity to facilitate acceptance of case management activities throughout the facility.
Minimum Job Qualifications
RN required. Master's Degree / MBA with 3-5 years of direct care giver experience in an acute care environment. In addition, 2-5 years in case management with some supervisory experience is required; knowledgeable of denials & appeals process.
Will also consider BA with a minimum of 5 years hospital based direct care experience in an acute care environment and a minimum of 5 years case management experience, 2 of which must be as a manager.
Licensure, Certification and/or Registration: RN, Case Management Certification preferred