Director of Case Management
3 weeks ago
Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 4,000 providers including Primary Care, Specialty, Hospital System and ancillary provider partnerships. We have operated in the Arizona market for more than 12 years, and are based in Chandler, Arizona. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.
The Director of Case Management is responsible for oversight, mentoring and evaluating with clinical staff within the Care Management Department.
Position Duties & Responsibilities
- Contribute to annual budget goals and encourage staff to reduce departmental costs.
- Establishes objectives and evaluate criteria for department, including TCM, CCM, Hospital/SNF Care Management, and specifies strategies to ensure success of these programs. Will ensure ongoing development, training, implementation and innovation of these programs.
- Develop and implement innovative strategies to improve care, so as to reduce admissions and ED visits.
- Works effectively and collaboratively with contracted partners and providers to improve patient care, ongoing communication, and decreasing frequency of emergency department visits and hospital admission/readmission, while maintaining high quality continuity of care.
- Change management – demonstrated ability, and preferable experience, in securing buy-in for new initiatives within Clinical Services team.
- Develop new strategies, and implement them to assure maximum engagement of beneficiaries, for interventions provided by AZPC.
- Identifies and prioritizes member needs based on clinical evaluations, while working with the multi-disciplinary teams to problem-solve, promote quality of care with cost effective outcomes and communicates findings to the appropriate person or department.
- Uses clinical judgement to triage the needs of PCP’s requesting case management and determines appropriate interventions.
- Communicates routinely with medical directors and apprises them of any inpatient/outpatient activity requiring immediate intervention.
- Develops, revises and implements department P&P’s, standard operating procedures (SOP’s) for identification, collection and analysis of performance measurement data, to continually improve department services, operations and reporting.
- Coordinates the appropriate documentation to assist with outpatient prior authorizations generated from inpatient hospitalizations, as part of discharge plan.
- Will annually review corporate UM Programs, as well as corporate P&P’s, and assist with modification to accurately reflect AZPC operations.
- Assists with investigation process of grievances, appeals and potential quality issues.
- Assists with developing instructional materials and conducts necessary training within department, ensuring maintenance of proof of training.
- Maintain awareness of advances in health care, government regulations, health plan changes, and member coverage options.
- Participates in annual health plan audit preparation and coordination, as requested.
- Will participate in QIC/UMC meetings, as requested.
- Responsible for annual evaluations of staff performance and ongoing mentoring.
- Responsible for reviewing Job applications and interviewing/hiring prospective team members.
- Oversees new hires orientation & training process in order for staff to perform at the expected level.
- Establishes and maintains effective internal and external professional relationships to facilitate a system-focused structure.
- Maintain a strong teamwork philosophy and willingness to accept change proactively.
- Other duties or special projects as assigned.
Education, Training and Experience
- Current, unrestricted AZ Registered Nurse license required.
- Bachelor’s degree in nursing or other health care field required; Master’s degree preferred.
- Minimum of 10 years acute hospital experience, with most recent year preferably in ER or ICU or other relevant clinical role requiring quick critical thinking experience required; 5 years’ experience in a managed care setting, directly related to care management functions, and experience with NCQA UM accreditation process.
- 5 years supervisory experience with advanced leadership skills required.
- Technical skills: Intermediate to Expert level Microsoft Excel, Word, PowerPoint, Outlook, NextGen, EZCAP, qHMO.
- Self-motivated with advanced assessment, analytical and problem-solving skills with ability to multi-task in a fast-paced environment with changing priorities is required, including ability to work independently.
- Exceptional organizational and project management skills including strong attention to detail and accuracy.
- Exceptional interpersonal, verbal and written communication skills, including proofreading and grammar skills.
- Must have the ability to train and present information accurately and communicate effectively with all levels of internal staff and external customers in a professional manner.
- Must have the ability to present clinical information both accurately and confidently.
- Able to communicate effectively and in a professional manner with all levels of internal staff and external customers.
- Driving occasionally required. Current and unrestricted AZ driver license with proof of insurance required.
- *This role requires FT in-office presence for the first 60 days of employment. Hybrid schedule available after initial training period.*
-
Director of Case Management
3 weeks ago
Chandler, Arizona, United States Arizona Priority Care Full timeDirector of Case ManagementArizona Priority Care is seeking a highly skilled and experienced Director of Case Management to join our team. As a key member of our Clinical Services Department, you will be responsible for overseeing the development and implementation of case management programs that improve patient outcomes and reduce healthcare costs.Key...
-
Director of Case Management
3 weeks ago
chandler, United States Arizona Priority Care Full timeArizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 4,000 providers including Primary Care, Specialty, Hospital System and ancillary provider partnerships. We have operated in the Arizona...
-
Director of Case Management
4 weeks ago
Chandler, United States Arizona Priority Care Full timeArizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 4,000 providers including Primary Care, Specialty, Hospital System and ancillary provider partnerships. We have operated in the Arizona...
-
Director of Case Management
3 weeks ago
chandler, United States Arizona Priority Care Full timeArizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 4,000 providers including Primary Care, Specialty, Hospital System and ancillary provider partnerships. We have operated in the Arizona...
-
Director of Case Management
1 month ago
Chandler, United States Arizona Priority Care Full timeArizona Priority Care (AZPC) is an Integrated Provider Network focused on providing Whole-Person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 4,000 providers including Primary Care, Specialty, Hospital System and ancillary provider partnerships. We have operated in the Arizona...
-
Case Manager
2 weeks ago
Chandler, United States Optum Full timeFor those who want to invent the future of health care, here‘s your opportunity. We‘re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Post-Acute Case Manager functions as part of the primary care team, and reports to the Supervisor, Post-Acute Case...
-
Case Manager
3 weeks ago
Chandler, United States Optum Full timeFor those who want to invent the future of health care, here‘s your opportunity. We‘re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Post-Acute Case Manager functions as part of the primary care team, and reports to the Supervisor, Post-Acute Case...
-
Travel Nurse RN
1 week ago
Chandler, United States Cynet Health Full time**Job Title:** Registered Nurse (RN) - Case Management**Job Specialty:** Inpatient Rehabilitation Facility (IRF) Division**Job Duration:** 13 Weeks**Shift:** Monday to Friday, 8:00 AM - 5:30 PM**Guaranteed Hours:** 36 weekly**Experience:** Minimum of 2 Years**License:** RN or Social Worker Licensed in Rehabilitation**Certifications:** **Must-Have:** Case...
-
RN Case Manager
1 month ago
Chandler, Arizona, United States United Surgical Partners Full timeRegistered Nurse Case ManagerArizona Specialty Hospital is seeking an experienced Registered Nurse to fill a full-time Case Manager position. The ideal candidate will have a strong background in nursing and case management, with excellent communication and organizational skills.Key Responsibilities:Utilize the nursing process to direct or provide nursing...
-
Case Manager
3 weeks ago
Chandler, Arizona, United States Southwest Network Full timeJob SummaryAs a Case Manager at Southwest Network, you will play a vital role in supporting individuals with serious mental illness. Your primary responsibility will be to develop and implement individualized service plans, ensuring that members receive the necessary care and support to achieve their recovery goals.Key ResponsibilitiesAssess and develop...
-
RN Case Manager Full Time
4 weeks ago
Chandler, United States United Surgical Partners Full timeArizona Specialty Hospital is seeking an experienced Registered Nurse Case Manager to join our team! This position is full time. The RN Case Manager responsibilities include: Working independently while handling multiple priorities simultaneously. Utilizes the nursing process of assessment, planning, implementation and evaluation to direct or provide...
-
Case Management RN
4 months ago
Chandler, United States trustaff Full timeAbout this job As a Case Management RN, you'll develop, implement, and evaluate individual patient care plans. You'll work with patients one-on-one to manage their care appropriately and affordably. Case Managers are important liaison, and you'll serve as a link between patients, their families, and healthcare providers. Qualifications: Basic travel nursing...
-
Travel Nurse RN Case Manager
4 weeks ago
Chandler, Arizona, United States Healthcare Support Full timeJob OpportunityHealthcare Support is seeking a skilled travel nurse RN Case Manager to join their team.Key Responsibilities:Provide exceptional case management services to patientsCollaborate with healthcare teams to develop and implement effective care plansEnsure seamless transitions of care for patientsCommunicate effectively with patients, families, and...
-
RN Case Manager Full Time
3 weeks ago
Chandler, Arizona, United States United Surgical Partners Full timeJob Title: RN Case Manager Full TimeArizona Specialty Hospital is seeking an experienced Registered Nurse Case Manager to fill a full-time position.Key Responsibilities:Work independently while handling multiple priorities simultaneously.Utilize the nursing process to direct or provide nursing care, ensuring optimal clinical, financial, operational, and...
-
Travel Nurse RN Case Manager
1 month ago
Chandler, Arizona, United States GHR Healthcare Full timeTravel Case Management Job OpportunityGHR Healthcare is seeking a skilled travel nurse RN case manager to join their team in Chandler, Arizona.Job Details:Specialty: Case ManagementDiscipline: RNDuration: 13 weeksHours: 40 hours per weekShift: 8 hours, daysEmployment Type: TravelAbout the Job:GHR Healthcare is a leading healthcare staffing agency with over...
-
RN Case Manager
5 days ago
Chandler, United States AMN Healthcare Full timeJob Details POSITION SUMMARY - RN Case Manager POSITION DUTIES - Discharge planning and utilization review MINIMUM REQUIRED QUALIFICATIONS - RN license LENGTH OF ASSIGNMENT - 13 weeks SHIFT / HOURS PER WEEK 40 hours, days SYSTEMS - Meditech and Midas START DATE - 11/18/24 Benefits Becoming an AMN Healthcare professional gives you the incredible...
-
Chandler, Arizona, United States Planet Healthcare Full timeJob TitleClinical Travel Nurse Case Management OpportunityAbout the OpportunityPlanet Healthcare is seeking a experienced travel nurse to fill a Case Management position.Key Responsibilities:Provide case management services to patientsWork closely with healthcare teams to ensure quality patient careCollaborate with multidisciplinary teams to coordinate...
-
Community Manager
2 months ago
Chandler, Arizona, United States MEB Management Services Full timeJob DetailsDescriptionWe are seeking a highly motivated and organized Community Manager to join our team at MEB Management Services. As a Community Manager, you will be responsible for leading the property team in daily operations, maintaining a positive and motivating presence, and ensuring the community runs smoothly.Key ResponsibilitiesManage and lead the...
-
Product Management Director
4 weeks ago
Chandler, Arizona, United States COMTECH TELECOMMUNICATIONS Full timeJob Title: Product Management DirectorComtech Telecommunications is seeking a highly skilled Product Management Director to lead our Digital product strategy and product lifecycle management. As a key member of our team, you will be responsible for creating and executing product roadmaps, managing the product lifecycle from concept to launch, and ensuring...
-
Director, Business Development
5 days ago
Chandler, United States Natives of Kodiak Inc Full timeGet the recognition you deserve. That's the everyday experience of working for the KOMAN family of companies! The Director of Business Development is responsible for strategy, research, analysis, and presentation of business opportunities for future direction and growth of the overall business sector. The position develops and implements planning and...
