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Manager of Case Management

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Listing Info

Master's in Nursing (MSN) Required.
MA RN license is required.
3-5 years experience is required.

Postion Summary: The Manager of Care Coordination will provide leadership to develop a care management model based upon a program goal of physician centered, seamless delivery of care across the continuum and will support Disease Management and Quality Improvement initiatives. The Manager will identify Care management needs and initiate a plan to develop, manage, and evaluate integrate patient delivery systems.The Manager of Care Coordinator will function, as a consultant in the management of care needs for all patients and will follow patients across the continuum and will participate in the systematic collection and evaluation of quality and variance data as well as utilization management data. The Manager of Care Coordinator will work closely with physician groups, the director of Managed Care and third party payers in all aspects of care management including utilization review, discharge plan, social services, quality resource management. Care management issues will be addressed through demonstrated critical thinking and creative problem solving by collaborating with members of interdisciplinary team, as identified by the manager. The Manager will assist in facilitating the achievement of optimal outcomes in a cost-effective manner.

Requirements

  • Masters Degree in nursing, or health care administration, or business administration preferred.
  • At least 3 years of care management and managed care experience.
  • Current Massachusetts license in nursing.
  • Strong understanding of managed care
  • Sound clinical judgment
  • Entrepreneurial
  • Excellent function development and management skills
  • Excellent communication and negotiation skills
  • Relationship manager - providers, committees, payers
  • Strong organizational skills


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