Responsibilities

The working Lead of Case Management is responsible for providing supervision to the case managers, social workers, coordinators/discharge planners, utilization review coordinators and utilization review technicians. Provides oversight for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

1. Licensed RN in your state.

2. Minimum 5 years of acute care experience

3. At least one-year experience in case management, discharge planning or management

4. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

1. CCM or obtained within 6 months of hire2. Knowledge of Milliman Criteria and InterQual Criteria preferred.3. Current BCLS certificate