| Job ID |
Specialty |
Geographic Location |
City |
State |
Recruiter |
| 2266132 |
Case Manager-RN |
33.6 miles South from Seattle |
Tacoma |
WA |
The Clinical Recruiter |
Company Name: The Clinical Recruiter
Recruiter Name: Kayleigh Stone
Contact Phone: 800-568-0828
Job Title: Manager of Care Management
In HouseID: 24860
33.6 miles South from Seattle (Only QUALIFIED Healthcare Professionals accepted) Case Manager-RN - Manager of Care Management
Seattle | Bellevue | Everett, Washington
JO# 24860
General Summary:
The Manager of Care Management leads and manages the day-to-day operations of utilization, clinical resource and case management departments and focuses on the continuum of care for the patient population.
· Develops case management programs that allows the hospital(s) to meet clinical resource management goals as well as third party and regulatory standards.
· Manages and educates staff at all levels about effective clinical resource management. Provides formal and informal programs.
· Maintains effective working relationships and effectively communicates the goals and objectives of the program to the medical staff, department staff, and others within and outside the hospital.
· Evaluates the effectiveness of existing clinical protocols and pathways and makes recommendations for new ones.
· Promotes organizational mission statement and goals and empowers staff and peers to achieve outstanding performance.
· Effectively reports departmental activities, goals, and measures of success.
· Works effectively with MCO staff and leadership to decrease denials or downgrades in reimbursement.
· Maintains department standards for regulatory and accreditation purposes.
· Actively seeks to resolve those issues brought forward by medical staff that have an adverse effect on patient outcomes.
· Analyzes the issues for cost|benefit in terms of improving clinical and financial outcomes.
· Prioritizes and recommends effective approaches that will improve clinical and financial outcomes in the hospital.
· Primary liaison between Case Management and the hospital Quality Committee.
· Recommends plans of care for high profile DRGs that incorporate effective Case Management strategies.
Experience:
· At least 3+ years Nursing Management experience in an acute care setting required
· Hospital Case Management experience required
· Managed Care Organization (MCO) experience preferred
Education:
· Bachelor of Science in Nursing (BSN) required
· Master’s Degree in Nursing or a related healthcare field preferred
Certifications|Licensures:
· Registered Nurse License required
· Certified Case Manager (CCM) a plus, not required
· Healthcare Quality of Utilization Review (HQUR) a plus, not required
Special Skills:
· Advanced communication and interpersonal skills
· Analytical and quantitative analysis skills
· Ability to lead a complex department to reach and exceed goals
· Ability to work with other departments
· Knowledge of Managed care trends, Medicare and Medicaid regulations
Referrer: nchcr.com