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Supervisor of Hospital Care Management
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Full-time
- Nature and Scope Incumbent is responsible for: Planning, organizing, managing and evaluating Utilization Management and Case Management teams.
- Provides expertise and direction to Hospital Care Management staff for solving complex clinical and financial patient situations regarding reimbursement issues, discharge planning, utilization review, continuity of care, and systems management.
- Demonstrated knowledge of: Utilization Management and Case Management principles and methodology Knowledge of Levels of Care (Acute care, Critical Care, Acute Rehab, LTAC, SNU, Subacute, Outpatient, Home Health, Day Tx.) Thorough working knowledge of: Government, county, private, and workers compensation funding sources.
- Eligibility criteria Criteria for determining level of care, and familiarity with managed care (HMO, PPO, PSO, and capitation) Federal and State regulatory requirements and URAC standards Demonstrated ability to: Communicate effectively with health care professionals and external case managers.
- Actively pursue continuing education and training opportunities in Utilization Management or Case Management.
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