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Case Management Manager- Utilization Management
3 months ago
Overview:
Montclair Hospital Medical Center is a 106-bed acute care, not-for-profit community hospital, received the "100 Top Hospital" in the nation award from IBM Watson Health, the Patient Safety Excellence award from Healthgrades, and the Women's Choice Award for America's Best Emergency Care.
At Montclair Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community
Montclair Hospital Medical Centes is a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
Paid Time Off
401K retirement plan
Outstanding Medical
Dental
Vision Coverage
Tuition Reimbursement
Many more
Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time.
This is a Fast-paced work environment in which you can take pride in serving an underserved community. Come Join a Team of Dedicated Healthcare Workers
Montclair Hospital Medical Center is nationally recognized, locally preferred, and community focused.
We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics.
Know Your Rights:
Privacy Notice for California Applicants:
Responsibilities:
The working Manager of the Case Management Department 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.
Qualifications:
EDUCATION, EXPERIENCE, TRAINING
Required qualifications:
- Licensed clinician in your state.
- Grandfathered prior to April 1, 2015. Minimum 5 years' post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
- Minimum 5 years' experience in a Case Management position.
- Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
- Experience and knowledge in basic to intermediate computer skills.
- Behavioral Violence Prevention Training within 3 months of hire and maintain current.
Preferred qualifications:
- Certification in Case Management, BS or BSN or related field preferred.
- Current BCLS certificate preferred.
- Knowledge of Milliman Criteria and InterQual Criteria preferred.
Montclair Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs.
Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.
Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary.A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $(phone number removed) to $(phone number removed) on an annualized basis.
The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
