Care Management Director
2 days ago
Job Summary:
The Care Management Manager is responsible for ensuring the delivery of quality services in accordance with established hospital, departmental, and regulatory/accreditation agency standards. This role oversees the overall operations of the Care Management department, including quality assurance and performance improvement initiatives, personnel management, budget preparation and monitoring, and employee compliance with hospital policies and procedures.
Key Responsibilities:
- Develop and implement departmental goals and objectives that align with the hospital's mission and strategic plan.
- Manage and supervise a team of care management professionals, providing guidance, coaching, and performance feedback to ensure high-quality patient care and service delivery.
- Collaborate with the UM manager and department director to develop and implement quality assurance and performance improvement initiatives that drive positive outcomes and patient satisfaction.
- Prepare and manage department budgets, ensuring compliance with hospital and regulatory requirements.
- Ensure employee compliance with hospital policies and procedures, including orientation, competency, and continuing education requirements.
- Participate in the hospital's Performance Improvement Program and contribute to the development of department-specific performance improvement initiatives.
- Communicate effectively with patients, families, and healthcare providers to ensure seamless care coordination and transitions.
- Stay up-to-date with regulatory requirements, industry trends, and best practices in care management to ensure the department remains compliant and competitive.
Requirements:
- Bachelor's degree in Nursing with RN license required; Master's degree in Nursing preferred.
- 5 years of managerial experience in an acute hospital setting, with previous experience as a case manager required.
- Knowledge of healthcare financial, regulatory, and payer issues, as well as state, local, and federal programs.
- Experience with Milliman/Interqual criteria and PRI/Screen certification preferred.
- C.C.M. certification preferred.
Work Environment:
The Care Management Manager will work in a fast-paced hospital environment, collaborating with interdisciplinary teams to ensure high-quality patient care and service delivery. The role requires strong communication and interpersonal skills, as well as the ability to work effectively in a dynamic and ever-changing environment.
Salary Range: $125,359.07-$188,049.62
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