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Manager, Case ManagementJob ID 18-671 Date posted 06/15/2018
JOB SUMMARY: Contributes to the Hospital's mission by being managing the Hospital's care coordinators which includes the functions of denial management, utilization review and discharge planning and with the clinical guidance of a licensed social worker, the hospital's social work services. As a member of the Hospital's leadership team provides day-to-day supervision to guide staff toward achieving the Hospital's success factor goals and their associated initiatives. This nursing leadership position will have an impact on our overall patient care as discharge planning and social work services are integral parts of the patient care process and on reimbursement by minimizing denials and accurately performing utilization review.
Required: Bachelor's Degree in Nursing
Preferred: Master's Degree in Nursing or a relevant field
5-year Requirement: Masters Degree in Nursing or relevant field (e.g. MPH).
• At least five years of case management experience with at least two years in a hospital setting.
• At least five years of acute hospital clinical experience as a Registered nurse in addition to the case management experience.
• Demonstrated ability to lead
• Experience with budget management.
• Prior supervisory experience
• Excellent oral, written, communication and organizational skills
• Extensive knowledge of denials management
• Strong Computer skills
• Knowledge of utilization review Criteria
• For safety and quality reasons, must be able to read, write and communicate effectively in English with patients, visitors and fellow members of the hospital team.
LICENSES, REGISTRATIONS, CERTIFICATIONS: Required:
• Massachusetts Registered Nurse License.
• Certified Case Manager or Acute Hospital Certified Case Manager within 1 year of hire