Case Manager ( Germantown PRN)-Care Management

Mercy Medical Center Clinton
Germantown, MD
Sep 24, 2021
Sep 26, 2021
Full Time
**Employment Type:**Part time**Shift: 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 Nurse+ BSN 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 13 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 Review+ Extensive 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.Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities, and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually.Based in Livonia, Mich., and with annual operating revenues of $17.6 billion and assets of $24.7 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity Health employs about 133,000 colleagues, including 7,800 employed physicians and clinicians.Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services ranked by number of visits in the nation, as well as the nations leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit . You can also follow @TrinityHealthMI on Twitter.

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