Description The Lead RN Case Manager is an individual who demonstrates leadership skills and knowledge of case management and progression of care. Strict interdepartmental development and interpersonal skills are required to effectively provide support to the RN Utilization Review and RN Case Manager teams, and maintain effective working relationships with other departments. Responsible for training teams and auditing services provided, to ensure the quality of care to patients served. This individual will be responsible for participation in staff consultations and direct coordination of care on complex cases throughout all units. Also responsible to intervene as necessary to remove barriers to timely efficient care delivery and reimbursement. Will also drive change by identifying areas where performance improvement is needed (e.g., day to day workflow, education, process improvements and patient satisfaction). Estimated salary range for this position is $87006.40 - $115718.51 / year depending on experience.
Qualifications:The Lead RN Case Manager is an individual who demonstrates leadership skills and knowledge of case management and progression of care. Strict interdepartmental development and interpersonal skills are required to effectively provide support to the RN Utilization Review and RN Case Manager teams, and maintain effective working relationships with other departments. Responsible for training teams and auditing services provided, to ensure the quality of care to patients served. This individual will be responsible for participation in staff consultations and direct coordination of care on complex cases throughout all units. Also responsible to intervene as necessary to remove barriers to timely efficient care delivery and reimbursement. Will also drive change by identifying areas where performance improvement is needed (e.g., day to day workflow, education, process improvements and patient satisfaction). Estimated salary range for this position is $87006.40 - $115718.51 / year depending on experience.Degrees:
Licenses & Certifications:
- ABMCM Certified Managed Care Nurse.
- NBCC Certification in Continuity of Care, Advanced.
- CCMC Case Manager.
- ANCC Nursing Case Management.
- ACMA Case Management Administrator Certification.
- NACCM Care Manager Certified.
- RNCB Certified Rehabilitation Registered Nurse.
- Registered Nurse.
- CDMS Certified Disability Management Specialist.
Additional Qualifications:
- Registered Nurse License.
- A Case Management Certification is required.
- Acceptable certifications: CCM Certification of Case Management, ACCC Advanced Certification in Continuity of Care, CDMS Certified Disability Management Specialist, CMAC Case Management Administrator Certification, CMC Care Manager Certified, CMCN Certified Managed Care Nurse, CRRN Certified Rehabilitation Registered Nurse, NCM Nursing Case Management.
- Current working knowledge of transitions of care, utilization management, case management and performance improvement.
- Current working knowledge of Milliman Care Guidelines and Interqual criteria.
- Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
- Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families.
- Excellent computer skills.
- Must possess excellent verbal and written communication, organizational skills, phone etiquette and interpersonal skills.
- High ethical and professional standards.
Minimum Required Experience: 2 YearsDegrees:
Licenses & Certifications:
- ABMCM Certified Managed Care Nurse.
- NBCC Certification in Continuity of Care, Advanced.
- CCMC Case Manager.
- ANCC Nursing Case Management.
- ACMA Case Management Administrator Certification.
- NACCM Care Manager Certified.
- RNCB Certified Rehabilitation Registered Nurse.
- Registered Nurse.
- CDMS Certified Disability Management Specialist.
Additional Qualifications:
- Registered Nurse License.
- A Case Management Certification is required.
- Acceptable certifications: CCM Certification of Case Management, ACCC Advanced Certification in Continuity of Care, CDMS Certified Disability Management Specialist, CMAC Case Management Administrator Certification, CMC Care Manager Certified, CMCN Certified Managed Care Nurse, CRRN Certified Rehabilitation Registered Nurse, NCM Nursing Case Management.
- Current working knowledge of transitions of care, utilization management, case management and performance improvement.
- Current working knowledge of Milliman Care Guidelines and Interqual criteria.
- Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
- Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families.
- Excellent computer skills.
- Must possess excellent verbal and written communication, organizational skills, phone etiquette and interpersonal skills.
- High ethical and professional standards.
Minimum Required Experience: 2 Years
