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Manager, Case Management (RN)
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Manager, Case Management (RN)

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Job Description


    The Manager of Case Management is responsible for providing leadership, management, and administrative direction to the Case Management department.
    The CM Manager will perform supervisory duties, such as, interviewing and making recommendations as to the hiring of new staff members, training staff, evaluating staff performance, and recommending and approving promotions or disciplinary actions.

     

    • Ensures compliance with all state and federal regulations related to Case Management and Social Services
    • Maintains the confidentiality of patient information, protects confidential and proprietary information about patients and the organization.
    • Responsible for the leadership of clinical care coordination, utilization management, discharge planning, and outcome management.  
    • Responsible for the oversight of the MediCal TAR process.   
    • Manages systems, processes, and outcomes of clinical care teams and programs designed to address clinical and financial needs of patients.
    • Acts as a representative of the hospital to internal and external clients, including patients and their families, physicians, administration, and health plans.
    • Assists the Systems Director in the development and updating of policies, procedures and protocols for department functions.
    • Create a positive working relationship with the Physician Advisor of the facility to ensure correct patient classifications, timely denials management, and development of collaboration with physician members and other departmental leaders within the hospital.
    • Participates in Utilization Review Committee functions.


Job Requirements


  • Valid CA RN license
  • BSN highly preferred. 
  • Minimum of 3 years experience in an acute case management department preferably in a leadership role.
  • Current BLS Card
  • Accredited Case Manager (ACM) preferred.
  • McKesson InterQual experience preferred. 
  • Knowledge of patient rights.
  • Ability to set priorities appropriately and handle multiple conflicts at once.
  • Ability to motivate staff members to work effectively and efficiently

 


 



 







Job Snapshot

Employment Type Full-Time
Job Type Health Care, Management, Nurse
Education 4 Year Degree
Experience At least 3 year(s)
Manages Others Yes
Industry Managed Care, Healthcare - Health Services
Required Travel Negligible
Job ID 05A*
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Manager, Case Management (RN)


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