Director Of Case ManagementReq #:0000189007 Category:Leadership Status:Full-Time Shift:Day Facility:Newark Beth Israel Medical Center Department:Case Management Location: Newark Beth Israel Medical Ctr, 201 LYONS AVENUE, NEWARK, NJ 07112-2027 Job Title:Director Location:Newark Beth Israel Medical Center Req#:0000189007 Status:Full-Time Shift:Day Department name:Case Management Job Overview: The Director of Case Management is responsible for the operational oversight of the Case Management Department, including but not limited to clinical resource management, utilization review, discharge planning, and patient advocacy. Responsible for the oversight of nursing and social work functions, medical necessity determinations, and concurrent reviews. This role is accountable for the execution, adaptation, and outcomes of case management as documented in the Utilization Management Plan, in alignment with state and federal guidelines. Qualifications: Required: + BSN required for RN; Master s Degree preferred, preferably in nursing + MSW required for SW; LCSW preferred + Minimum 5 years clinical experience in hospital, home health, or community setting + Minimum 3 years recent experience in Case Management/UR/Discharge Planning required + Minimum 2 years supervisory experience is required + Current and valid license to practice as a Registered Nurse or Social Worker in the state of New Jersey + Certification in Case Management strongly preferred/required within 1 year of hire + Working knowledge of healthcare reimbursement systems required + Expert knowledge related to application of medical necessity criteria Preferred: Certifications and Licenses Required (if applicable): + N/A Scheduling Requirements (non-exempt positions): + Day + Full-Time + 37.5 Hour Work Week Essential Functions: + Expert knowledge of regulations regarding utilization review, discharge planning, auditing, scopes of practice for case management and social work, + Ability to establish and maintain effective working relationships with the all customers, internal and external, + 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, 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 families + Excellent working knowledge of denials management + Knowledge of professional standards for RN Case Managers and Social Workers, + Excellent knowledge of state and federal regulations regarding Utilization Management, Discharge Planning and hospital billing Strong ability to lead, mentor and inspire people Benefits and Perks: At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to supports our employees physical, emotional, social, and financial health. + Paid Time Off (PTO) + Medical and Prescription Drug Insurance + Dental and Vision Insurance + Retirement Plans + Short & Long Term Disability + Life & Accidental Death Insurance + Tuition Reimbursement + Health Care/Dependent Care Flexible Spending Accounts + Wellness Programs + Voluntary Benefits (e.g., Pet Insurance) + Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more! Choosing RWJBarnabas Health! RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health. RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education. Equal Opportunity Employer RWJBarnabas Health is an Equal Opportunity Employer