A DC/Baltimore area 600-bed Medical Center seeks an Assistant Nurse Director of Case Management Utilization Review to join their reputable healthcare organization.
The Assistant Director of Case Management and UR is responsible for managing, supervising, and evaluating Inpatient Case Management procedures and policies, via the delivery and implementation of the admissions and discharge programs. The Assistant Director will oversee all staff activities and management.
The Assistant Director will report to the Director of Case Management and Utilization Review and is responsible for a staff of 60 full-time RN Case Managers. The Assistant Director of Nursing Case Management will work closely with the Manager of Social Work. Bith leaders will collaborate with the Director, sharing responsibility and accountability for the department's operational management, leadership, professional development, and quality assessment.
This Care Management Nurse leader will serve as a clinical consultant to RN Case Managers, providing guidance and intervention with challenging situations. The Assistant Director will have experience in leadership and hospital Case Management background.
Additional Opportunities include:
- 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 advisors, and external review organizations to ensure quality outcomes.
- Collaborates with the denials prevention and management staff to ensure a low medical necessity denial rate.
- Support the mission of the hospital and national healthcare organization
The right candidate has the extensive clinical nursing experience and gained progressive leadership experience in Case Management, Care Management, or Utilization Review within an acute care hospital. This nurse leader has a BSN with leadership experience. That background supplemented by an MSN or a CCM will earn interviews.
Areas of expertise
- Payer mechanisms
- 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
- Demonstrated ability to lead through collaboration and influence.
The Case Management Assistant Nurse Director will have the opportunity to live in one of the nation's most iconic regions. The Medical Center is surrounded by beauty with endless recreational, cultural and outdoor activities just a short drive away. The area features a thriving economy, numerous public and private universities, multiple professional athletic teams, and culturally diverse communities.
The Medical Center is part of a stable and national healthcare organization and is prepared to offer a generous salary, comprehensive benefits package, and a lucrative bonus plan. We cannot wait to tell you more about this role!