Director Care Management

Phoebe Putney Health System; Albany (GA); On-site; USD 120,000 - 170,000; Full time

Job summary

Phoebe Putney Health System is seeking a Director of Care Management to lead the CM program, staff, and operations, including budgeting, planning, and regulatory compliance. The role sets priorities and provides administrative leadership for utilization review, care coordination, denial management, social work, and transition planning.

The position requires a 4-year degree in Nursing or Healthcare Administration, plus 4+ years in acute care case management and 5+ years of management, with RN

Qualifications

• 4 year Bachelor's Degree in Nursing, Healthcare Administration (Required).
• Master's Degree in Nursing or related field (Preferred).
• 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).
• Registered Nurse (RN) with a current Georgia license OR a Licensed Clinical Social Worker (LCSW).
• CCM, Accredited Case Manager, Case Management Administrator Certified preferred.

Responsibilities

• Direct the overall Care Management program, staff, and operations including budgeting, planning, and regulatory compliance.
• Set priorities and provide administrative leadership for utilization review, care management/care coordination, denial management, social work, and transition planning.
• Provide leadership to ensure department roles and functions support outcomes involving appropriate level of care, resource utilization, revenue cycle activities, safe patient discharge, care transitions, and readmission prevention.
• Collaborate with the Physician Advisor and participate in System and Organizational Performance Improvement initiatives; build relationships with stakeholders; educate about CM program functions, payer, and regulatory requirements including current trends.

Education

Bachelor's Degree in Nursing or Healthcare Administration

Master's Degree in Nursing or related field

CCM

Accredited Case Manager

Case Management Administrator Certified

RN with Georgia license

LCSW

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)

Experience Requirements

• Master's Degree in Nursing or related field (Preferred)
• 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