Social Media Manager

Director of Care Management / RN Licensed:

• Direct Hire
  
• Full-Time (Days)
  
• Competitive Compensation, based on
  
• Excellent Benefit Package
  
• Location: Geneva, NY (Finger Lakes Region)
  
• (Ability to Travel the short drive from Geneva to Penn Yan)
  

Reports: Chief Medical Officer

Department: Care Management

Supervises: CARE MANAGER, RN UTILIZATION REV, SECRETARY, SOCIAL WORKER MSW

Education: Masters in Social Work, Business or Nursing

License: Current NYS RN license required

Experience:

• Acute Care
  
• Minimum: Five years experience in a healthcare
  
• Three years experience in utilization management or denial
  
• Knowledge and experience in developing utilization management and revenue recovery
  
• Experience dealing with authorizations and appeals
  
• Knowledge of discharge planning and clinical case management
  
• Knowledge and experience in project management and team
  
• Knowledge of and experience with basic research methods and statistical
  
• Preferred: DRGs, Medicare Regulations,
  
• Medical Necessity Criteria,
  
• Patient Bill of Rights,
  

Responsibilities:

• Supervises professional and clerical employees who work with a range of functions, including but not limited to access, pre-authorization and precertification, bed placement, coding, utilization review and denial management, care coordination collaborative treatment planning and core measures, discharge planning, clinical social work, tracking of the post-acute period and provision of disease management, and contracting internally and
  
• Partners with the CMO for effective relationships with physicians, services, specialties,
  
• Provides consultation to the executive team, forming effective relationships with all VPs and department
  
• Participates in the determination and definition of the Care Management Dashboard, using data to better understand strengths and weaknesses of the department, and to determine needs, decisions, and
  
• Establishes, implements, and evaluates a written strategic plan for the department that takes into account internal and external
  
• Establishes, manages, and constantly evaluates staffing levels, assignments, skills, learning needs, and deployment of
  
• Creates stable and reliable processes to anticipate and address specific situations within the department and between the department and other departments and
  
• Establishes effective communication systems and forums with third party payers, the local PRO/QIO, Medical Records, and the managed care and finance
  
• Develops structures and processes to facilitate participation by physicians, physical therapists, social work, and other health professionals in multidisciplinary care planning, care delivery, and discharge
  
• Participates in continuous quality improvement
  
• Negotiates, approves, and manages the operational and capital
  
• Writes and conducts annual and interim performance appraisals for all staff in the
  

Ability to facilitate project management, work effectively under pressure, meet deadlines, manage multiple priorities and enhance the spirit of teamwork through effective role Familiarity with JCAHO Excellent leadership, interpersonal, communication (written and oral), analytical, and organizational Demonstrated ability to deal effectively with the public in a professional and courteous Computer literacy required with word processing, spreadsheets, power

• Education: Masters in Social Work, Business or Nursing
  
• License: Current NYS RN license required
  
• Acute Care Experience