Manager - Case Management

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

The working Manager of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs. Integrates and coordinates services using continuous quality improvement tools. Responsible 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. 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.

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

Licensed clinician in your state.
1. Grandfathered prior to April 1, 2015. Minimum 5 years' post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
2. Minimum 5 years' experience in a Case Management position.
3. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
4. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

1. Certification in Case Management, BS or BSN or related field preferred.
2. Current BCLS certificate preferred.
3. Knowledge of Milliman Criteria and InterQual Criteria preferred.