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Director of Care Management

Director of Care Management

Job Description

CCS’s Philosophy

CCS’s philosophy is based on the Five H’s - qualities we value in all our team members. The5 H’s are the foundation of how we do business – with our clients, our patients, and our teammates.

• HUNGER - We have the fire to learn, teach, and grow. We encourage each other and ourselves. Teamwork helps everyone reach their goals from the smallest unit to the company as a whole.

• HONESTY - We uphold the highest level of integrity in all our dealings with each other, with clients, and with our patients. Everyone is treated with respect and dignity.

• HARDWORKING - We are willing to outwork and out-think the competition so we remain constant in placing our customers first. We strive for quality in everything we do.

• HUMILITY - No matter how much success we achieve it’s important to remember not to lose our identity. We maintain our loyalty to our community by being good citizens in the areas that we live and work.

• HUMOR - Given the amount of time we put towards our work it is important to have a sense of humor. This allows us to remain passionate and enjoy our work.

Job Purpose:
The Director of Care Management, in collaboration with the Vice President of Care Management, is responsible for the management, oversight and strategic planning for the Director and in that the Director is responsible to ensure Care Management processed are efficient. The RCM team is supported and team building occurs.
Essential Functions:
•Work in collaboration with business the RCM team reports to owners to design and implement. Initiatives in the Care Management department and in overlapping functions, such as claims, site clinical partners and clinical division.
•Care Management liaison to effect improved communication, reporting and work flow efficiencies with cross functional teams.
•Provide training and education for the Care Management Department and other staff as needed to support Care Management. Initiatives and the use of supporting resource tools, such as Track Via and ERMA
•Collaborate with Vice President of Care Management, Special Projects Specialist, Clinical Leadership, IT Leadership, and Operations Leadership I the development of application enhancements to support Care Management process.
•Oversight of Medical Review program.
•Oversight of Care Management Policies and Procedures.
•Assist with special projects as assigned by the Vice President of Care Management.
•Second seat to the Vice President of Care Management.

CCS is an EEO Employer

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Job Requirements

Education:
•Graduation from an accredited School of Nursing
Experience:
•Depth of experience in initiating and implementing quality improvement processes.
•5+ years’ experience with clinical and claims applications.
•5+ years experiences in business analysis including: workflow analysis, design and implementation of applications to support business needs including improved outcomes and reporting.
•10+ years’ experience in management of direct reports and operations management.
•5+ years’ experience in Case Management/Utilization Management.
•Experience in implementation of new/revised applications to support Quality initiatives; 5+ years’ experience training super-users and end-users, including the development of training materials and providing both web-based and in-person training.
•Profound computer proficiency with specific skills in MS Word, Excel, Power Point and Share Point.
•Excellent interpersonal and communication skills (verbal and written).
Licenses/Certifications:
•Current Registered Nursing Licensure and CCM and Quality certification

Job Snapshot

Employment Type Full-Time
Job Type Health Care
Education 2 Year Degree
Experience Not Specified
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Not Specified
Job ID 3002
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Director of Care Management


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