The Assistant Director of Case Management is responsible for assisting the Director of Case Management with the case management program, including the functions of case management, utilization management, and discharge planning for the Hospital. The Assistant Director will help assess and evaluate the care/services rendered, staffing levels, competency and educational needs of the case management staff and effectively coordinates and controls resources. The Assistant Director provides consultation and education to facility leadership, clinical and financial personnel, the Board of Trustees, and medical staff members related to case management including utilization management and discharge planning practices. The Assistant Director participates in the annual review of the Case Management/Utilization Management Plan of the hospital.
- Current and valid license to practice as a Registered Nurse in the state of New Jersey
- MSN preferred
- Certification in Case Management required within 1 year of hire.
- Two years recent experience in Case Management/UR/Discharge Planning required.
- Working knowledge of healthcare reimbursement systems required.
- A minimum of 2 years supervisory experience is required.
- Excellent knowledge related to application of medical necessity criteria
- Microsoft Office skills, word, excel, power point, and others
- Expert knowledge of regulations regarding utilization review, discharge planning, auditing, scopes of practice for case management and social work.
- Excellent interpersonal communication and negotiation skills.
- Strong analytical and data management skills.
- Expert working knowledge of discharge planning, utilization management, case management, care coordination, performance improvement, and managed care reimbursement.
- Expert working knowledge of pre-acute and post-acute levels of care and community resources.
- Strong organizational and time management skills as evidenced by capacity to prioritize multiple tasks and role components.
- Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families.
- Broad clinical knowledge base of disease processes and expected outcomes.
- Excellent working knowledge of denials management.
- Knowledge of professional standards for RN Case Managers and Social Workers.
- Excellent knowledge of federal regulations regarding Utilization Management, Discharge Planning and hospital billing.
- Strong ability to lead, mentor and inspire people.
We are committed to High Reliability and consistent demonstration of our Safety Together behaviors and tools:
S - Speak up for Safety
A - Accurately communicate
F - Focus on the task
E - Exercise and accept a questioning attitude
T - Thoughtfully interact
Y - You and Me Together
RWJBarnabas Health is an Equal Opportunity Employer
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