(Archived) Director of Care Management

Our Director of Care Management is second to the Vice President of Care Management in the management and direction of the corporate Care Management programs.

Provide direction of day to day functions of the Care Management Department.Provide clinical perspective and best practices support to RCM staff through one-on-one coaching, team facilitation, and training.Work to improve the utilization management process, including considerations of efficiency, effectiveness, and accuracy.Develop and implement RCM care management processes in collaboration with the Vice President of Care Management to support corporate UM initiatives.Promote and maintain positive relations with all stakeholders.Provide clinical and operational oversight of each medical management initiative including utilization management. Analyze clinical data to drive each initiative.Review and revise Care Management and Utilization Management program descriptions annually or as indicated by contract or accreditation requirements.Responsible for training RCM staff including new employee orientation and skill development.Identify opportunities to improve clinical care, customer service, and internal business processes.Collect, report, trend, and analyze Care Management program elements for departmental productivity and performance outcome reporting.Assist Vice President of Care Management in planning and conducting Care Management Committee functions.Develop, manage, and participate in intra- and inter-departmental projects, workflow processes, policies and procedures in collaboration with internal and external stakeholders.Responsible for staff performance evaluation and management.

CCS is an EOE/Minorities/Females/Vet/Disability Employer

Education:

• Graduate from an accredited School of Nursing.

Experience:

• Previous experience in care delivery in a managed care environment
• Correctional environment preferred
• Previous experience working with utilization management
• Computer data entry needed

Licenses/Certifications:

• Current license as a Registered Nurse