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Manager Of Case Management Job Details

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Company:  Nurse Resolutions
Job Code:  1631
Categories:  Skilled Nursing / Nursing Home (SNF)
Job Role:  Other
Country:  United States
Region/Province:  Mississippi (MS)
City:  Jackson
Job Description: 

Position Purpose: Perform duties to conduct and manage the day-to-day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.

Knowledge/Experience: Bachelor’s degree in nursing, social work, or behavioral health, or equivalent experience. 3 – 5 years case management experience. Thorough knowledge of case and/or utilization management. Familiarity with Medicaid and Medicare managed care practices and policies, Children’s Health Insurance Program (CHIP), and State Children's Health Insurance Program (SCHIP).

Competencies: Manager: Integrity, Flexibility, Communication, Critical Thinking, Building a Successful Team, Decision Making, Planning and Organizing, Building Strategic Working Relationships, Technical and Professional Knowledge

Position Responsibilities:

•Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes for case management. •Promote compliance with federal and state regulations and contractual agreements. •Develop, implement and maintain compliance with policies and procedures regarding medical and social case management. •Develop, implement, and maintain case management programs to facilitate the use of appropriate medical and community resources and decrease health plan financial exposure. •Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries. •Develop staff skills and competencies through training and experience.

Licenses/Certifications: State driver’s license and automobile insurance. Case Management Certification (CCM) preferred.

We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

Abe Ghebrehiwet
Senior Account Executive
Nurse Resolutions
888.411.2228. Toll Free
407.341.9647. Cell
407.982.7508. Fax
www.NurseResolutions.com

case manager, case management, utilization review, utilization management, managed care, oak brook, Illinois

Post Date:  05/24/2012
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