Job Opportunity Details

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

Job Description

This is a Case Manager-RN Opportunity Only!

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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




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