RN Director Case Management

Location: El Paso, Texas
RN DIRECTOR CASE MANAGEMENT
**Bonus & Relocation Assistance Available**

Responsibilities
  • The individual in this position has overall responsibility for operational management of the Case Management Department; including staffing, budgets and plans. The individual’s responsibilities will include, but not be limited to the following activities:
  • Complying with relevant company policies including Case Management and Clinical Determination Policies
  • Implementing and revising the UM Plan and promoting cooperation with utilization review standards by the medical staff
  • Maintaining / facilitating communication between the case management department and the physician advisor on a regular basis regarding utilization review and/or quality issues
  • Maintaining / facilitating communication between the case management department and the physicians as well as other members of the healthcare team
  • Analysis of reports: LOS, avoidable days, disputes, InterQual and  associated metrics
  • Responsible for implementation and compliance with all policies and regulations relating to the functioning of the case management department
  • And all other duties as assigned
 
Qualifications
  • Bachelor's degree in nursing, Master's degree preferred
  • Extensive management and clinical experience
  • 3 years of experience as a case manager preferred
  • Experience in patient data, healthcare staff documentation related to patient care, regulatory and payer requirements, and budgetary and operations data
or
this job portal is powered by CATS