Case Manager ( Germantown PRN)-Care Management
Employment Type:Part timeShift:Description:The Manager-Care Management & Utilization Review, under the supervision and in collaboration with the Director, is responsible and accountable for the operational management, leadership, professional development and quality assessment and improvement activities of the department, particularly the Care Managers. Manages the activities of hospital staff in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities and agencies on regulations affecting patient status and insurance. Collaborates and maintains positive working relationships with physicians, physician advisor and external review organizations to ensure quality outcomes, patient throughput, and appropriate resource utilization while supporting the HCH mission. Collaborates with the denials prevention and management staff to ensure a low medical necessity denial rate. Supports the Mission of Trinity Health and Holy Cross Hospital. Location: Germantown Minimum Licensure/Certification Required (if applicable): State of Maryland license as a Registered NurseBSN acceptable, MSN Degree preferred. Minimum Knowledge, Skills, and Abilities Required: At least 3 years of experience in hospital case management or related activity.At least 10 years clinical of Nursing experience in an acute healthcare setting.Minimum of 1-3 years management/supervision/leadership experience in an acute healthcare setting required.Preferably with case management, utilization review or closely related area.Designation Changes and Utilization ReviewExtensive knowledge of payer mechanisms and clinical utilization management is required. Knowledge of pertinent regulatory, accreditation, public and private service organizational activities relating to discharge planning and resource utilization. Evidence of prior successful interaction with external review organizations. Demonstrated ability to establish and maintain effective interpersonal relationships with all levels of personnel, medical staff, and community, as well as a demonstrated ability to work effectively with interdisciplinary teams. Demonstrated ability to lead through collaboration and influence. Reads, writes, speaks and comprehends the English language. Computer literacy and analytic skills required.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.