Lead/Manager Case Management
Atlanta, GA US
LEAD/MANAGER CASE MANAGEMENT
The Lead/Manager Case Management is a registered Nurse responsible for managing the Case Managers within the department. This position reports to the Director of Case Management and will have approximately 15 FTE’s (7 to 8 Case Managers and a data position).
Looking for an individual who is able to step into the Director role in her absence. Act as the right hand person to the director. Collaborating and working strategically with the Director on moving the Department forward. Solid acute care case management experience, able to be hands on if necessary.
Clinically organized and familiar with an “integrated model for the full Case Management scope of practice”.
Reviews, Discharge Planning, Concurrent Appeals, Denials, Avoidable Days/Variances, Reports, Enterprise, Kronos, Interqual, Excel, Medical Staff Relationships, Staff Development
Using a collaborative interdisciplinary approach the Lead/Manager will confirm the Case Managers are providing a plan of care and focus on anticipation, integration, and coordination of clinical care and discharge planning services necessary to meet the needs of patients in order to optimize clinical outcomes and resource utilization. Ensuring the Case Managers are acting as an advocate for the patient, physician, and hospital relative to compliance with federal, state and third party utilization management regulatory requirements.
REQUIRED EDUCATION, TRAINING, and/or EXPERIENCE: Hospital based leadership experience as an RN or Case Manager required. Experience in case management, utilization review, discharge planning.
REQUIRED LICENSES and CERTIFICATION: Licensed in State of Georgia as a Registered Nurse or eligible. BSN and CCM preferred.
OTHER REQUIRED SPECIAL SKILLS and KNOWLEDGE: Knowledge of community resources used for discharge planning, hospital operations, excellent communication / presentation skills, and knowledge of third party payment systems, Medicare / Medicaid programs. Maintains current knowledge base of case management practices through continuing education. Ability to multi-task, set priorities and maintain organization.