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Vice President, Case Management

Med-Metrix

Brooklyn, NY

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JOB DETAILS
SALARY
$210,000–$225,000 Per Year
JOB TYPE
Full-time
SKILLS
Acute Care, Authentication, Blood-Borne Pathogens, Case Management, Clinical Best Practices, Communication Skills, Content Management Systems (CMS), Customer Support/Service, Federal Laws and Regulations, Genetics, HIPAA (Health Insurance Portability and Accountability Act), Health Science, Healthcare, Hospital, Hospital Administration, Infectious Diseases, Information/Data Security (InfoSec), Interpersonal Skills, Leadership, Management Strategy, Metrics, Microsoft Office, Military, Nursing, Office Equipment, Operational Strategy, Operations Planning, Performance Metrics, Peripheral Hardware, Presentation/Verbal Skills, Privacy Regulations, Problem Solving Skills, Quality Monitoring, Regulations, Regulatory Requirements, Safety Standards, Security Compliance, Smartphones, Social Work, Spreadsheets, Standards of Care, State Laws and Regulations, Strategic Planning, The Joint Commission (TJC), Time Management, Utilization Management, Word Processing, Writing Skills
LOCATION
Brooklyn, NY
POSTED
30+ days ago
Job Purpose The Vice President, Case Management provides leadership and direction to related to Case Management initiatives and clinical priorities. This person works collaboratively with leadership to lead strategy related to Case Management ensuring stakeholder inclusion and alignment. The Vice President, Case Management is responsible for strategic planning and the advancement of case management, to include utilization management, coordination of care and transition management. The Vice President, Case Management develops and executes operational strategies built to ensure the Case Management strategy is aligned with regulatory requirements, organizational goals and forward thinking aimed at efficiency and viability. Duties & ResponsibilitiesExecutive management of Case ManagementOversees Case Management and social work activities to monitor quality of careDevelops and implements strategy and actions plans in alignment with the organization’s strategic planning processEnsures strategies developed and deployed related to performance metricsEnsures alignment with regulatory guidelines and organization goalsAdjusts strategy as indicated by performance metrics and/or organization needAssures evidence-based practice and clinical best practice care standards, outcomes and metrics are established and held accountableCollaborates with other department leaders to assure the smooth integration of Case Management/Social Work services across the continuumMonitors and maintains JCAHO, federal and state regulatory readinessActively participates in the formulation and revision of administrative and departmental case management policies and proceduresCommunicates and interprets policy additions/revisions to staffOther duties as assignedUse, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standardsUnderstand and comply with Information Security and HIPAA policies and procedures at all timesLimit viewing of PHI to the absolute minimum as necessary to perform assigned dutiesQualificationsBachelor’s Degree in NursingMaster’s Degree in Nursing and other health care related courses – Preferred Minimum of 10 years acute care clinical experienceMinimum of 10 years case management leadership experienceNew York State Licensed Registered Professional NurseCertification in Patient Review Instrument (PRI) and ScreenCertification in Case ManagementCertification in Hospital Management strongly preferredBroad knowledge of medical, nursing, and allied health sciences, community resources case management regulatory requirements, and the revenue cyclePC experience word processing, spreadsheets, and case management/denials software structuresStrong understanding of CMS Conditions of Participation as it relates to utilization management, coordination of care and transition managementKnowledge of HIPAA and privacy regulations, healthcare laws, regulations and standardsDemonstrated leadership ability requiredProficiency in Microsoft Office SuiteStrong interpersonal skills, ability to communicate well at all levels of the organizationStrong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analysesHigh level of integrity and dependability with a strong sense of urgency and results oriented Excellent written and verbal communication skills requiredGracious and welcoming personality for customer service interactionWorking ConditionsMust possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposesPhysical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. Perform light lifting (up to 15 pounds)Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stressWork Environment: Works in a well-lighted/ventilated office setting. Subject to frequent interruptions. Minimal occupational exposure to infectious diseases, blood borne pathogens, hazardous chemicals, noxious odors, latex, or musculoskeletal injuries. Operate Office machines properly and in accordance with Hospital safety standards. Ability to work in accordance with Hospital Safety StandardsMed-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

About the Company

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Med-Metrix