Job details
Director of Care Management / RN Licensed:Direct HireFull-Time (Days)Competitive CompensationAbility to Travel the short drive from Geneva to Penn YanReports: Chief Medical OfficerDepartment: Care ManagementEducation: Masters in Social Work, Business or NursingLicense: Current NYS RN license requiredExperience:Acute CareMinimum: Five years experience in a healthcare settingThree years experience in utilization management or denial managementKnowledge and experience in developing utilization management and revenue recoveryExperience dealing with authorizations and appealsKnowledge of discharge planning and clinical case managementKnowledge and experience in project managementKnowledge of and experience with basic research methods and statistical analysisMedical Necessity CriteriaPatient Bill of RightsResponsibilities:Supervises professional and clerical employees who work with functions such as access, pre-authorization, bed placement, coding, utilization review, denial management, care coordination, discharge planning, and disease management.Partners with the CMO for effective relationships with physicians and services.Provides consultation to the executive team, forming effective relationships with all VPs and departments.Participates in the determination and definition of the Care Management Dashboard, using data to assess department strengths and weaknesses.Establishes, implements, and evaluates a strategic plan for the department.Manages staffing levels, assignments, skills, and learning needs.Creates reliable processes to address specific situations within and between departments.Establishes effective communication systems with third party payers and other stakeholders.Develops structures to facilitate multidisciplinary care planning and discharge.Participates in continuous quality improvement initiatives.Negotiates, approves, and manages operational and capital expenditures.Conducts annual and interim performance appraisals for all staff.Qualifications:Education: Masters in Social Work, Business or NursingLicense: Current NYS RN license required
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Confidential
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Social Media Marketing Academy for Health & FitnessAED 799Duration: Upto 130 Hours
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Social Media Marketing – Advanced 1TRAININGAED 83
AED 563Duration: Upto 30 Hours
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