Nurse Manager - Case Management
Day Shift (Hours: 8a-4:30) No Weekends or Holiday
ChristianaCare Wilmington Hospital is looking for an energetic, motivated Nurse Manager for our Case Management Department to manage the daily operations of longitudinal care management, precertification, appeals and denials for patients in the acute care setting.

Daily contact with Physicians, Case Managers, Patient Financial Services, HIMS, and Managed Care Organizations. Frequent contact with the nursing department, ancillary departments, healthcare and referring community facilities and agencies. Regular communication with Directors, Physician Advisors, and Social Work.

Assigned supervisors, case manager, case management assistants and social workers.

Manages daily operations of the Care Management Team and Serves as an expert resource or staff and Christiana Care leadership related to care management functions .
Evaluates and provides feedback/recommendation of information technology software that allows for comprehensive, longitudinal care management of an identified population of patients.
Facilitates the development of care management guidelines, algorithms, and protocols.
Develops and implements applicable care management processes, policies, and procedures.
Prepares and reviews annual performance appraisals with employees.
Develops systems and processes to effectively manage collaborative relationships with external third-party payers.
Identifies areas of potential compliance risk and develops strategies to mitigate risk in collaboration with the Compliance Officer and staff.
Maintains strong working relationship with compliance office and staff and actively engages in all compliance activities as requested.
Develops processes for the accurate capture of data to maintain a care management dashboard reflective of key performance measures.
Collaborates with Data Informatics team to analyze data and makes recommendations for program development/changes based on data analysis.
Collaboration with the key internal stakeholders, develops and implements processes, policies & procedures to manage the transition of patients effectively and efficiently in accordance with state, federal and payer standards and regulations.
Demonstrates knowledge of local, state, and federal reimbursement guidelines.
Maintains a collaborative professional relationship with clinicians and administrative staff to develop, implement, and evaluate successful process outcomes.
Bachelor’s degree required.
Five years experience in Case Management in an Acute Care hospital setting is preferred.
Three years supervisory/management experience preferred.
All candidates must be able to maintains required documented hours of relevant continuing education related to licensure requirements.

Ability to ambulate with the hospital setting. Ability to utilize computer equipment.

Frequent travel to multiple sites as needed. Occasional exposure to office materials. Normal office environment.