Director of Case Management and Utilization Review
4 weeks ago
Day Kimball Healthcare is seeking a highly skilled and experienced Director of Case Management and Utilization Review to join our team. As a key member of our leadership team, you will be responsible for managing a multi-talented team responsible for facilitating the patient plan of care throughout the continuum of care.
Key Responsibilities:- Provide management direction to the RN Case Managers and assigned clerical and utilization management staff in the department.
- Identify appropriate staffing levels, assignments, and deployments for the department and monitor performance criteria for staff members.
- Review operations of the Case Management department to ensure high levels of quality are consistent with organization standards.
- Provide leadership through education on case management and utilization management concepts, committee work, research, and community involvement.
- Facilitate the patient plan of care throughout the continuum of care by ensuring appropriate utilization management, care coordination, resource utilization, and clinical documentation.
- Assist with collecting, analyzing, evaluating, and presenting clinical management and operations data to the Leadership Team for achieving the overall goals and objectives of the department and the organization.
- Act as primary liaison between providers, patients, and families, members of the interdisciplinary team, and outside agencies to assure high-quality care that meets the patient's needs and is delivered in a cost-effective and timely manner.
- In-depth understanding of anatomy, physiology, medical terminology, and disease processes.
- Knowledge of CPT coding, resource management systems, electronic medical record, and basic computer skills.
- Demonstrated leadership, independent problem-solving, conflict resolution, critical thinking skills, and team building skills.
- Self-motivated and able to work as part of a diverse team with minimal supervision.
- Ability to work well within a creative and challenging work environment.
- Experience in utilization review, ability to navigate medical records, value-based purchasing metrics, or pre-certification.
- Exceptional team orientation; strong sense of commitment to team members and patient impact.
- Additional nursing experience in specialty area is preferred.
- Registered Nurse (RN) or Master's in Social Work (MSW).
- A minimum of three (5) years of experience in Case Management is preferred.
- Additional specialty certification/training as required by the work area.
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Case Management Director
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Putnam, Connecticut, United States Day Kimball Healthcare Full timeDirector of Case Management & Utilization Review$10,000 Sign on Bonus32/40 hours, hybrid opportunityGreat benefitsOverviewDay Kimball Healthcare invites you to be part of our team where you'll discover a culture of teamwork, professionalism, mutual respect, and a life-changing career. Our Nurse Managers - Case Management play a vital role in forging the path...
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