Job Requirements

General Summary

Assists the Director of Population Health in the management of the Care Management Department in association with the Care Managers in accordance with regulatory requirements and the needs of the hospital. Assumes shared responsibility for ensuring optimal clinical and financial outcomes across provider lines and systems in conjunction with all members of the healthcare team.

Reporting Relationships

Reports to the Director, Care Management

Qualifications

Bachelor of Science in Nursing or Social Work required, Master's degree preferred. Must be currently licensed as a registered nurse or social work in the state of Maryland. Minimum of 5 years of experience in case management which includes 2 years of experience in progressive management responsibilities. Experience and understanding of third party payer regulations, case management methodologies and other regulatory requirements related to case management and cost containment required. Milliman Care Guidelines training desirable.

Must have excellent writing skills; strong organization skills, ability to perform multiple tasks with interruptions and manage time effectively to achieve simultaneous goals. Must demonstrate excellent interpersonal skills to effectively communicate with physicians, hospital personnel and external agencies, both verbally and in writing. Must have strong problem-solving skills, demonstrated by effective problem identification and problem-solving. Must have experience with automated databases. Demonstrates a commitment to group goals and teamwork.

Working Conditions

Normal office environment and unit clinical setting. Works inside a clean, well-lighted environment. May be exposed to frequent interruptions and multiple demands. Work is high demand. Potential for minimal exposure to communicable diseases and hazardous materials requires the observance of standard precaution and safe handling practices. This position has been classified as low or no exposure risk and does not require the completion of an annual testing, but may require "just in time" testing if the need arises.

Physical Requirements

Must be able to sit for most of work period. Standing, walking, stooping, and bending are required. Must articulate clearly and have excellent listening skills for telephone communication and interacting with internal and external customers. Possesses visual acuity to read medical records, department literature, data reports and video viewing display monitors is required. Lifting is usually of less than 25 pounds with frequent handling of records and reports. Reaching for and handling of equipment and supplies is required. Manual dexterity required to use a keyboard.