Manager, Case Management
4 weeks ago
Position: Manager, Case Management
Client: Large Payer Client
Location: Hybrid (Indianapolis, IN)
Duration: 6-month contract with the possibility of going FTE
Start: ASAP
Overview:
This position is responsible for supervision and oversight of assigned Case Managers. Responsible for the frontline supervision and management of deployed case managers, resource coordinators, and other support staff. Ensure that staff are successfully completing their required case load and the operational priorities identified and defined by other leadership. They are responsible for ensuring appropriate handling of all data collected by case managers.
Requirements:
- Bachelors Degree in Nursing required.
- Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
- 3-5 years of managerial experience required
- Certification in Case Management preferred.
- Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
- Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
- Ability to comprehend third party contractual arrangements is preferred.
- Understanding of the third party denial and appeal process is preferred.
- Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
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