Director Care Management

Phoebe Putney Health System; Albany (GA); On-site; USD 120,000 - 180,000; Full time

Job summary

A healthcare system in Georgia is seeking a Director of Care Management to oversee the program and operations, ensuring compliance and patient safety. The ideal candidate will have a Bachelor's degree in Nursing or Healthcare Administration and over four years of acute care case management experience. Leadership skills are essential, as the Director will work with various departments and stakeholders to enhance care coordination and resource utilization. A current RN or LCSW license in Georgia is required, along with preferred certifications such as Certified Case Manager.

Qualifications

• 4+ years of acute care case management experience required.
• 5+ years of management and leadership experience, with at least 2 years at the Director level in a comparable setting required.
• 4+ years of Acute care case management experience is required.
• 5+ years of management and leadership experience with a minimum of 2+ years at the Director level in a comparable setting is required.
• RN with a current Georgia license OR a Licensed Clinical Social Worker (LCSW) is required.
• Certified Case Manager (CCM) and related certifications are preferred.

Responsibilities

• Directs overall Care Management program, staff, and operations.
• Leads administrative functions of utilization review and care coordination.
• Collaborates with stakeholders to improve performance and outcomes.
• Build relationships with key internal and external stakeholders and provide education about CM functions, payer, and regulatory requirements.

Skills

Leadership

Strategic planning

Regulatory compliance

Resource allocation

Budgeting

Stakeholder management

Education

4 year Bachelor's Degree in Nursing, Healthcare Administration

Master's Degree in Nursing or related field

Job description

Responsible for directing the overall Care Management program, staff, and operations including resource allocation, budgeting, planning, and regulatory compliance. The Director CM sets priorities and provides administrative leadership for functions of utilization review, care management/care coordination, denial management, social work, and transition planning. He/she provides leadership and direction to ensure department roles and functions support consistent practice and outcomes involving appropriate level of care, resource utilization, associated revenue cycle activities, safe patient discharge, care transitions, and readmission prevention. The Director works collaboratively with the Physician Advisor and participates in System and Organizational Performance Improvement initiatives; works to build relationships with key internal and external stakeholders; provides education about CM program functions, payer, and regulatory requirements including current trends and potential impact on the department, hospital or system.

Education Requirements

• 4 year Bachelor's Degree in Nursing, Healthcare Administration (Required)
• Master's Degree in Nursing or related field (Preferred)

Experience Requirements

• 4+ years of Acute care case management (Required)
• 5+ Years of Management and leadership experience with a minimum of 2+ years at the Director level in a comparable setting (Required)

Certifications and Licensures

• Required Certifications/Licensures: Registered Nurse (RN) with a current Georgia license OR a Licensed Clinical Social Worker (LCSW)
• Preferred Certifications/Licensures: Certified Case Manager (CCM), Accredited Case Manager, Case Management Administrator Certified