Care Management Director

  •  

Queens, NY

Industry: Staffing & Recruiting

  •  

5 - 7 years

Posted 337 days ago

JOB DESCRIPTION

The Care Management Director:

  • Reviews department clinical services and operations
  • Oversees activities of onsite Care Managers
  • Develops relationships and seeks feedback from internal and external stakeholders regarding the implementation of department activities to garner satisfactory customer results
  • Emphasizes a collaborative approach and seeks to influence other services by focusing on patient processes
  • Develops and implements Utilization Review (UR) based on internal data collection, data received from external agencies, Physician Advisors and the Medical Director
  • Ensures Discharge Appeals functions are carried out within contractual, federal and state guidelines
  • Presents and reviews data relative to avoidable days, denials, length of stay and other key metrics to leadership
  • Maintains necessary levels of staff qualifications, competencies, staffing levels (hiring and discharge), regulatory compliance, individual development plans, continuing education and performance appraisal
  • Works collaboratively with Admitting, Transfer Services and Finance to ensure appropriateness of admissions and proper reimbursement

REQUIRED SKILLS

  • BSN
  • Active New York State Registered Nurse license
  • 5+ years of experience as a manager or director
  • Experience in hospital UR / Care Management
  • Strong clinical background in nursing

J141132

$125K - $150K