Job Alert: Director of Case Management

The role of the Director, Case Management Support Services is a unique blend of clinical expertise and operations prowess. The job requires a process driven approach, taking on tasks with a sense of urgency and flexibility. The Director must respond to a diversity of projects and tasks by developing an operational plan, implement and manage the project, all the while juggling other competing responsibilities. Team management skills, especially honed from a call center experience, are used often and are a key to the success in this job.

Key Performance Indicators:
Data/Systems Driven, Process Focused, Results Oriented, Organized, Flexible, Able to manage multiple projects or initiatives simultaneously, Experience managing in a highly regulated environment

Experience operationalizing a program (i.e.. call center), Registered Nurse – preferred but not required, Operations experience – in a clinical environment preferred, Comfortable with managing through data , Ability to fully maximize system and staff capabilities

Want to learn more? Contact Richard Yadon 866-371-0687

Case Manager |RN |IL |Search

Medicaid Case Manager RN

Medicaid Case Manager RN

Join an organization that TRULY values their nurses! This is a rare opportunity for an RN with experience in UR to step into a managed care setting with plenty of room for growth. Review inpatient admissions to assure appropriate level of care and medical necessity. This will be done on site and tele phonically. Audit patient charts through on-site hospital visits, act as clinical resource to referral staff and make appropriate referrals. Educate patients and providers. Enters assessments, authorizations and reviews into the system.

Position requires an RN with min. 2 yrs clinical exp and UR exp. Current state nursing and driver’s license.

Knowledge/Experience: At least two years clinical nursing experience.

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Sr. Clinical Systems Specialist| Informatics RN |Search

Tech-savvy RN will promote medical management processes and manage application integration throughout numerous areas of the organization to promote effective collaboration. Identify opportunities for process adjustments and redesign related to new business, new and existing programs. Formulate and manage work plans related to system or process initiatives. Direct and/or perform testing related to application upgrades and/or modifications. Maintain all aspects of the application described as clinical content. Monitor, analyze and coordinate resolution of large scale application issues related to the transfer of member and provider, and/or authorization data. Maintain MM web page for the Clinical System Management Unit. Work as a team with other RN’s performing similar work.

Bachelor’s degree in nursing, RN, 5-7 years of related experience. Project management in a clinical environment preferred. Ability to integrate nursing knowledge to enhance business optimization and application development. Ability to travel approximately 20%.

Executive Recruiting Contact:
Pamela Ratz DeVille, CPC, CIR, CDR
DL: 866-371-0687 x256
PamD@MedicaidServices.net

Apply Here