Manager of Care Management

apartmentNational Coalition Of Healthcare Recruiters placeTacoma descriptionPermanent calendar_month 
Only QUALIFIED Healthcare Professionals accepted) Case Manager-RN - Manager of Care Management
Seattle | Bellevue | Everett, Washington

JO# 24860

General Summary:
The Manager of Care Management leads and manages the day-to-day operations of utilization, clinical resource and case management departments and focuses on the continuum of care for the patient population.
Develops case management programs that allows the hospital(s) to meet clinical resource management goals as well as third party and regulatory standards.
Manages and educates staff at all levels about effective clinical resource management. Provides formal and informal programs.
Maintains effective working relationships and effectively communicates the goals and objectives of the program to the medical staff, department staff, and others within and outside the hospital.
Evaluates the effectiveness of existing clinical protocols and pathways and makes recommendations for new ones.
Promotes organizational mission statement and goals and empowers staff and peers to achieve outstanding performance.
Effectively reports departmental activities, goals, and measures of success.
Works effectively with MCO staff and leadership to decrease denials or downgrades in reimbursement.
Maintains department standards for regulatory and accreditation purposes.
Actively seeks to resolve those issues brought forward by medical staff that have an adverse effect on patient outcomes.
Analyzes the issues for cost|benefit in terms of improving clinical and financial outcomes.
Prioritizes and recommends effective approaches that will improve clinical and financial outcomes in the hospital.
Primary liaison between Case Management and the hospital Quality Committee.

Recommends plans of care for high profile DRGs that incorporate effective Case Management strategies.

Experience: At least 3+ years Nursing Management experience in an acute care setting required

Hospital Case Management experience required

Managed Care Organization (MCO) experience preferred

Education: Bachelor of Science in Nursing (BSN) required

Masters Degree in Nursing or a related healthcare field preferred

Certifications|Licensures: Registered Nurse License required

Certified Case Manager (CCM) a plus, not required

Healthcare Quality of Utilization Review (HQUR) a plus, not required

Special Skills: Advanced communication and interpersonal skills

Analytical and quantitative analysis skills
Ability to lead a complex department to reach and exceed goals
Ability to work with other departments

Knowledge of Managed care trends, Medicare and Medicaid regulations

apartmentQuail ParkplaceLynnwood, 40 mi from Tacoma
Resident Care Coordinator | RCM Quail Park of Lynnwood Have you always wanted a fun and rewarding job? Do you have a sincere passion for working with seniors? If so, come join the Quail Park of Lynnwood team as a Resident Care Manager! What You'll...
placeSeattle, 25 mi from Tacoma
annual bonus eligibility, and more! Responsibilities: The Clinical Care Manager serves as part of a self-directed work team to provide care management and therapeutic connection for clients with disabling HIV/AIDS in Outpatient Services and clients...
placeSeattle, 25 mi from Tacoma
Center Nurse Case Manager (RN-NCM)  •  National Academy of Certified Care Managers: Care Manager Certified (CMC)  •  Highly organized, self-directed worker able to function in a high-volume environment without distractions.  •  Strong verbal and written...