DIRECTOR, CARE MANAGEMENT-Jeanes Campus
2 weeks ago
The Director of Care Management is responsible for the overall management and integration of the Care Management and Social Work Services for the TUH Jeanes Campus. The Director provides administrative oversight of assigned areas and programs to meet the hospital tripartite mission of patient care, research and education. The Director is responsible for developing, analyzing and maintaining a data base for Care Coordination Services and for measuring outcomes. This Director assists the hospital to identify delays in service, gaps in coordination of care, poor communication between departments, over or under use of hospital services. The Director of Care Management has overall responsibility for all utilization review activities on the TUH Jeanes Campus as defined by TUHS contracts, as falls within the scope of practice of the Care Management Department and is necessary to meet the financial needs of the organization. These responsibilities include, but are not limited to, all concurrent utilization review activities as it relates to telephonic review, all clinical pre-certification responsibilities, all retrospective review responsibilities and all insurance company and business office concurrent determination follow-up and communication.
Education
Bachelors Degree : in Nursing or a related field. (Required)
Masters Degree : in Nursing or a related field. (Preferred)
Combination of relevant education and experience may be considered in lieu of degree.
Experience
5 Years experience in Case Management or Utilization Management in either a hospital or insurance company (Required)
General Experience and knowledge of InterQual criteria (Required)
License/Certifications
RN-LIC - PA Registered Nurse License (Preferred)
_ '238024
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