Care Coordination is a collaborative practice model including the multidisciplinary health care team, the patient and family, and community services and resources. The Care Coordination process encompasses analysis of information, use of evidence-based guidelines, communication among the care team and patient/family and facilitates care along the continuum through effective resource coordination. Overarching goals, in alignment with the Crouse Mission, Vision and Values, include the achievement of optimal health, access to care and appropriate utilization of resources, balanced with the patient’s right to self-determination.

The Manager of Case Management is responsible for providing day to day management of the RN Care Managers in the department. 

The areas of authority are Discharge Planning and all functions related to this. Responsibilities include general operational oversight including hiring training and evaluating staff.  Representation of the department on assigned committees and work groups.  Developing and implementing workflows, policies, procedures and auditing performance.  The manager is the point person for problem escalation and troubleshooting for the staff.  The Manager stays abreast of the regulatory environment specific to areas of responsibility and develops and implements strategies for compliance.  The Manager works closely with the UM and Appeals and Denials staff as both areas work in tandem to facilitate the best outcomes for our patients and organization.
  EDUCATION / CERTIFICATION / LICENSURE Required: Licensed as a Registered Nurse in New York State.  Bachelor's Degree EXPERIENCE Required: A minimum of five (5) years previous case management/ discharge planning in an acute care setting or other care continuum experience in a clinical setting. Knowledge of regulatory requirements related to acute care discharge planning. Preferred:     Acute care utilization review experience. Previous leadership experience. SPECIAL SKILLS/EQUIPMENT Working knowledge of MS Office.  Expert knowledge of clinical review criteria such as InterQual, Milliman or other.  Working knowledge of CMS regulations pertinent to UM, Discharge Planning, beneficiary rights and benefit coverage.
 

Salary Range: $90,000+

*Based on verified education & experience