Interim RN Director Case Management and Utilization Management
Ascension
- Hanover, MD
- Interim
- Full-time
- Department: Ascension Interim Leadership Travel Program
- Schedule: Monday - Friday, 8am-5pm, on call as needed
- Hospital: St. Agnes
- Location: Baltimore, Maryland
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics.ResponsibilitiesCase Management:
- Provides leadership to and actively participates with facility staff to identify, implement, or enhance CM programs consistent with Ascension and Market strategy
- Identifies process improvement opportunities; develops, implements, monitors, and revises action plans
- Actively seeks to identify and share best practices • Disseminates information accurately and timely with multiple audiences; leads regularly scheduled communication sessions with hospital CM Directors
- Facilitates CM education within the Market; provides orientation and onboarding support to new hospital CM leaders
- Identifies and proposes opportunities to improve current technology or identifies new technology to enhance performance and productivity
- Escalates issues to Market leadership and Sr Dir of CM as appropriate • Performs other duties as assigned
- Ensures integration of utilization management functions with network strategy and claims processing.
- Oversees work with provider relations on resolving issues.
- Manages activities related to staffing, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.
- Develops systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to implement and manage comprehensive outpatient and inpatient utilization management programs.
- Oversees implementation and maintenance of prior authorization codes for all clients.
- BLS Provider obtained within 1 Month (30 days) of hire date or job transfer date required. American Heart Association or American Red Cross accepted.
- Registered Nurse obtained prior to hire date or job transfer date required.
- Bachelor's degree in nursing or diploma from an accredited school/college of nursing required. Master's degree or combination of Bachelor's degree and experience preferred.
- 5 years of experience required.
- 10 years of experience preferred.
- 2 years of leadership or management experience required.
- 5 years of leadership or management experience preferred.
- Master's preferred.
- Certified as ACM-RN or CCM preferred.