Inpatient Manager

4 weeks ago


MA United States Ignyte AI Full time
Job Summary

The Inpatient Manager is responsible for overseeing the day-to-day operations of the Utilization Management (UM) Process, ensuring the effective management of medical management activities related to utilization and discharge planning for acute inpatient, LTAC, rehabilitation, and skilled nursing facilities. This role requires collaboration with various departments and staff to identify opportunities for service improvement, cost reduction, and outcomes enhancement.

Key Responsibilities
  • Business Process Implementation and Oversight
    • Develop, implement, and monitor new and existing medical management programs for inpatient utilization and discharge planning, ensuring compliance with regulatory requirements.
    • Collaborate with case management program leaders to transition care needs, manage complex discharge planning, and address high-risk members.
    • Establish written policies and procedures for Utilization Management and Transition of Care/Discharge Planning, ensuring adherence to regulatory standards.
    • Ensure compliance with contractual service agreements with network, vendor, and employer business partners.
  • Staff Development
    • Provide direct oversight of Team Managers within jurisdiction.
    • Guide and enhance the professional development of reporting staff, providing coaching, feedback, and direction through a development plan.
  • Resource Management
    • Support budget process and oversee the management of department resources.
    • Accountable for realization of department administrative budget targets.
Qualifications
  • BS degree in nursing required; Master's degree preferred.
  • Registered Nurse with current Massachusetts license preferred.
  • 7 years' Registered Nurse, Leadership experience in managed care systems required.
  • Demonstrate sound knowledge of utilization management and case management principles.

Point32Health is committed to making diversity, equity, and inclusion part of everything we do. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.



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