Director, Care Management - Full Time - Day Shift
About The Position
The Director, Care Management directs the function and personnel of the care management department. The role develops, manages, and oversees the annual care management budget; prepares and evaluates monthly, quarterly, and annual departmental reports; and monitors and communicates changes in Medicare regulations and documentation issues to physicians and others. The director also maintains relationships and contractual oversight with key stakeholders and local, state, and federal agencies. The position develops and motivates the care management team to achieve department goals, analyzes utilization metrics, oversees on-site monitoring reviews by outside review organizations and third-party payers, and supports education and monitoring of utilization patterns. Other job-related duties may be assigned.
Requirements
- Bachelor’s degree or equivalent combination of education and related experience.
- Registered Nurse (RN), Medical Degree (MD or DO) and current unrestricted California licensure to practice, or Licensed Clinical Social Worker (LCSW).
Nice To Haves
- Master's degree.
- Seven years of hospital discharge planning, utilization review, case management, and social work experience.
- Five years of leadership experience.
- Licensed Master Social Worker (LMSW) - State Board.
Responsibilities
- Direct the function and personnel of the care management department.
- Develop and motivate the care management team to accomplish department goals and objectives.
- Develop, manage, and oversee the annual care management budget.
- Prepare and evaluate monthly, quarterly, and annual reports of the department's functions.
- Provide information regarding changes in Medicare regulations and documentation issues to physicians and others as needed.
- Analyze and monitor utilization metrics and communicate findings as appropriate.
- Oversee accountability for on-site monitoring reviews by outside review organizations and third-party payers.
- Maintain relationships and contractual oversight with key stakeholders, including education and monitoring of utilization patterns.
- Maintain working relationships with local, state, and federal agencies.
- Perform other job-related duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Director
