About the role
Overview
Assists the Director to administer operations and activities of the Utilization Case Management Department in support of policies, goals and objectives established by the Hospital by providing direct supervision to the Utilization Case Management Coordinators with an emphasis on the concurrent review process. Ensures compliance with standards of Regulatory Agencies, including the Joint Commission on the Accreditation of Healthcare Organizations and New York State/City Department of Health. Oversees the implementation of Utilization Case management Program objectives.
Responsibilities
- Establish and maintain positive relationships with patients, visitors, and other employees. Interacts professionally, courteously, and appropriately with patients, visitors and other employees.
- Contributes to and participates in the Performance/Quality Improvement activities of the assigned department. Contribution and participation includes data collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement
- Assist the Director with administrative activities as they relate to the departmental goals and objectives including attending on-site and off-site meetings, participating in hospital wide work teams and responding to requests and inquiries in the absence of the Director.
Qualifications
Master's Degree in Nursing, Health Care Management or related field
National Certification in Case Management, PRI/Screen assessor number
Certified Professional Coder (Preferred)
Experience in Utilization, Performance Improvement, Managed Care, Case Management, Discharge Planning Risk Management or Health Care Administration.
Registered Professional Nurse with current License and minimum of three (5yrs) managerial experience