Care Management ManagerPosted: March 28, 2013
Responsible and accountable for clinical and financial operations of the Care Management system. The manager provides hospital-wide leadership through effective managerial and educational direction in the areas of Care Management operations, resource management, and patient flow through the continuum. DRG financial analysis, change management, managed care, guidelines, protocols, clinical documentations and systems improvement. Independent action is required to ensure an integrated process which will coordinate health care delivery across service lines. Frequent interfaces with Senior Leadership, Medical Staff, Quality, Ancillary Services and Nursing in a communicative and change management capacity. Promotes high quality patient care and cost effectiveness by proactively coordinating the entire spectrum of patients’ care; facilitates positive outcomes with appropriate use of resources.
Salary Range: $33.47 - $50.21
Schedule: Full time
Contact: Gayle Martinez
• Graduate of an accredited school of nursing required. BSN preferred.
• Current licensure to practice as a Registered Nurse in the State of New Mexico. Certification in Care Management preferred. Current BCLS required.
• Requires a minimum of five years recent acute care nursing experience.
• Three years demonstrated nursing management in fast pace, complex environment. Multidisciplinary approach to clinical improvement.
• Fiscal Management. Management Care concepts and strategies;
• DRG reimbursement. Convert DRG and Physician practice pattern data information into qualifying data which impacts costs and quality.
• Ability to implement new programs and problem solving mechanisms.
• Strong interpersonal communication skills.
• Experience in developing and presenting education programs.
• Competent computer skills to include Microsoft Office programs.
• Excellent knowledge of Medicare/Medicare/Third Party admission and concurrent review criteria.
• Knowledge of “Benchmark” and “Best Practice” methodologies.
• Care Management Practice/Guidelines, to include analyzing, trending and reporting variances.
• Working knowledge of Milliman
This Position is No Longer Available
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