Job Description* Job Summary * Assists the Director with the overall operational direction of the Case Management Program. Serves as aresource person in all aspects of utilization management. Supervises the staff in performing utilization review. * Minimum Qualifications * Education/Training * Bachelor's degree in Nursing or related Healthcare Management field; Master's degreepreferred. * * Experience * 3 years utilization review or case management experience; 5 years clinical experience in anacute care facility; management or supervisory experience. * * License/Certification/Registration * * Valid RN license in the State of Maryland. * Knowledge, Skills & Abilities * Excellent verbal and written communication skills. Basic computer skills preferred. * Primary Duties and Responsibilities * Assists Director with the preparation of annual report for Utilization Review to the State Department of Health and Mental Hygiene. * Assists in the development and recommendation of department operating budget and ensures that the department operates within the budget. * Assists with developing, evaluating, recommending, and implementing policies and procedures. * Assists with the overall operational direction of the Case Management Program through the integration of social work, utilization management, and case management functions to achieve identified objectives. * Contributes to hiring and termination decisions, new staff orientation, development of job descriptions and performance standards, schedules and monitors assignments, and controls staffing levels to meet budgetary guidelines. * Interfaces with external agencies (eg, home health agencies, skilled nursing facilities, durable medical equipment, Delmarva) and provides appropriate information, consultation, or recommendations. * Participates in meetings and on committees and represents the department and hospital in community outreach efforts as required. * Participates in multidisciplinary quality and service improvement teams. * Performs other duties as assigned. * Provides counseling and training, addresses disciplinary problems, and appraises performance. Assists in the evaluation of age specific assessment, plans, and delivery of care provided by staff. Shows sensitivity to the special needs of specific age groups. * Serves as a resource person in all aspects of utilization management for all Medical Staff and ancillary departments to assure hospital compliance with TJC standards and State and Federal regulations. * Supervises the Case Management Staff in performing utilization review in accordance with guidelines and regulations established by the hospital board, Administration, Medical Staff, accreditation and certification agencies, and Federal and State governments. About MedStar Health MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, DC, region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.