Job description

Job Title:

RN Manager of Care Management

Employment Type:

Full Time

Shift:

Day

About us:

Holy Cross Health is a Catholic, not-for-profit health system that serves more than 240,000 individuals each year from Maryland's two largest counties — Montgomery and Prince George's counties. Holy Cross Health earns numerous national awards, clinical designations and accreditations across a wide range of specialties for providing innovative, high-quality health care services.

We were named one of America’s 100 Best Hospitals for 2022.

(SUMMARY) Position Highlights:

• Competitive pay
• Additional Benefits: Relocation assistance, tuition reimbursement, free parking
• Quality of Life
• Advancement: Opportunities to advance through the Clinical Advancement Program
• Location: Holy Cross Health has two hospitals and four healthcare centers all a short driving distance from Washington DC and Baltimore, MD

Description:

• Full-Time 8am – 4:30pm
• Reporting to the Director of Care Management
• The RN Case Manager Supervisor is responsible and accountable for the operational management, leadership, professional development and quality assessment and improvement activities of the department, particularly the Care Managers. Manages the activities of RN Case Managers for in inpatient care coordination and utilization review. Oversees interactions of staff with outside activities and agencies on regulations affecting patient status and insurance.

Responsibilities:

• Works collaboratively with the Nursing Director and Sr. Director of Care Management
• Conduct clinical supervision with all case managers and serve as a resource for the team.
• Responsible for the compliance, tracking and trending of incident reporting procedures
• Attend daily huddle/weekly interdisciplinary team and administrative meetings.
• Manage the daily operations of the Nurse Case Managers and serve as a resource for the team
• Collaborates and maintains positive working relationships with physicians, physician advisor and external review organizations to ensure quality outcomes, patient throughput, and appropriate resource utilization while supporting the HCH mission.
• Assists with the denials prevention and management staff to ensure a low medical necessity denial rate. Supports the Mission of Trinity Health and Holy Cross Hospital.

What you will need:

• State of Maryland license as a Registered Nurse
• BSN required; MSN Degree preferred.
• At least 3 years of experience in hospital case management or related activity.
• Minimum of 1–3 years management/supervision/leadership experience in an acute healthcare setting required.
• Extensive knowledge of payer mechanisms and clinical utilization management is required

Preferred:

• At least 5-7 years clinical of Nursing experience in an acute healthcare setting.
• Designation Changes and Utilization Review
• Knowledge of pertinent regulatory, accreditation, public and private service organizational activities relating to discharge planning and resource utilization. Evidence of prior successful interaction with external review organizations. Demonstrated ability to establish and maintain effective interpersonal relationships with all levels of personnel, medical staff, and community, as well as a demonstrated ability to work effectively with interdisciplinary teams.

Holy Cross Health is an Equal Employment Opportunity (EEO) employer status.

Job Types: Full-time, PRN

Benefits:

• 403(b) matching
• Continuing education credits
• Dental insurance
• Disability insurance
• Employee discount
• Free parking
• Health insurance
• Health savings account
• Life insurance
• Paid sick time
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance
• Wellness program

Schedule:

• Day shift
• Holidays
• Monday to Friday

Work setting:

• Hospital
• Outpatient

Ability to commute/relocate:

• Silver Spring, MD 20910: Reliably commute or planning to relocate before starting work (Required)

Experience:

• RN Case management: 5 years (Required)

License/Certification:

• RN (Preferred)

Willingness to travel:

• 25% (Preferred)

Work Location: In person

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