Lead Case Manager-Care Management

Location
Silver Spring, Maryland
Salary
Competitive
Posted
Sep 14, 2021
Closes
Sep 16, 2021
Ref
00271503
Function
Analyst, Research
Industry
Healthcare
Hours
Full Time
Employment Type:

Full time

Shift:

Day Shift

Description:

The Lead Case Manager is a senior clinician in the Care Management department. With the manager, develops and implements standards which enhance the quality of case management interventions, consistent with the professional model and with the mission and policies of Holy Cross Hospital. Provides process oversight and education toward new staff orientation, staff competency development, and the continuous documentation improvement program (CDIP). The Lead Case Manager is responsible for assisting with the daily operations within the department. Assists the leadership team with employee supervision, management, and training; data research and analysis. Guides team in resource management. Maintains the standard for a collaborative process of assessment, planning, facilitation, and advocacy for patients in our care. Individualizes services to meets patient's health care needs by utilizing available resources to promote quality outcomes.

Minimum Licensure/Certification Required:
  • RN, Licensed by State of Maryland.

Minimum Knowledge, Skills, and Abilities Required:
  • At least two years case management experience required, to include Quality Improvement and Clinical Documentation enhancement experience in the acute hospital setting.
  • RN with BSN required, Master's Degree in Nursing or Certification in Case Management preferred.
  • Previous management/supervisory experience preferred.
  • Leadership skills required for role include effective mentoring, coaching, time management, problem solving, and strategic planning. Demonstrates initiative and pro-active approach to problem resolution.
  • Working knowledge of criteria for Medicare, Medicaid, HMO, and private insurance carrier's coverage details-to advocate for patients.
  • Ability to effectively interact with insurance companies and community healthcare recourses.
  • Must have strong Microsoft Office Products, i.e. Excel, Word etc. Understand patient status, InterQual Criteria, and Milliman Criteria.
  • Ability to work with all age groups of patients.


Holy Cross Health is an Equal Employment Opportunity (EEO) employer. Qualified applicants are considered for employment without regard to Minority/Females/disabled/Veteran (M/F/D/V) status.

Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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