Altamonte Springs, Florida
Birmingham, Alabama
Posted: 15-Sep-23
Location: Louisville, Colorado
Salary: Open
Internal Number: 23034471
Description
All the benefits and perks you need for you and your family:
- Paid Days Off from Day Oneâ¯
- Student Loan Repayment Programâ¯
- Career Developmentâ¯â¯
- Whole Person Wellbeing Resourcesâ¯
Our promise to you:â¯â¯
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind, and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.â¯â¯
Schedule: Full-time Shift: Day
Location: 100 Health Park Drive Louisville, Colorado 80027
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The role you'll contribute:
The Manager is responsible for the daily operations, long term planning and budget of the CM department in accordance with the Utilization Management Plan and department policy and procedures. The Manager is responsible for data management and reporting as mandated by Federal, State and Community regulatory agencies including QIO activities and Corporate required reporting. Personnel management and supervision of case management Fosters cooperative working relationship with members of the Case Management team, physicians and patients to provide quality coordination and progression of care activities including discharge planning & utilization review. Plans, organizes, implements, and evaluates the activities of the Case Management Department, which include the functions of utilization management, discharge planning, social work services, and spiritual care as well the integration of these functions with fiscal services. Works closely with directors, physicians, nursing/clinical staff, and fiscal services to ensure that services provided by the department serve to optimize quality of patient care, utilization of hospital resources, and reimbursement by third payers.
The value you'll bring to the team:
- Reviews current professional standards for each program and makes recommendations for changes in policy, procedures, equipment, and assignments.
- Establishes and implements department goals and outcomes with involvement of staff in accordance with Patient Business Services goals and the hospital’s strategic planning goals.
- Keeps staff informed of their responsibilities as well as activities and accomplishments of the hospital-wide programs.
- Demonstrates care for one another and respect for each person’s unique contributions.
- Consider factors related to patient safety, effectiveness, cost, and impact on practice in the delivery of Case Management services.
- Daily oversight of utilization review activities to ensure compliance with Medicare and Medicaid as well as contractual agreements with Managed Care contracts.
- Operates within designated budget to maintain expenditures within allocated funds, initiates actions to correct or seeks approval to maintain budget variances.
- Maintains open dialogue with payers regarding utilization, case management, and discharge planning issues.
- Identifies and assists staff to maintain current information on community resources.
- Demonstrates evidence of continuous professional development. Identifies own learning needs and seeks opportunities for self-growth and career advancement.
The expertise and experiences you’ll need to succeed:
Required:
- Current RN license in Colorado or licensure from another state with verification of application of eligibility for Colorado licensure by endorsement.
- Two years in Case Management or like experience.
- One-year experience at a supervisory/manager level.
- Experience with PC applications required (such as word processing, spreadsheets, and graphics).
- Excellent interpersonal skills, oral and written communication skills required.
Preferred:
- MSN or health related degree.
