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Job Details

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About This Employer


Connecting employers with the talent they need + connecting healthcare professionals with the jobs they’ll love

Headquartered in New York City with 9 additional offices in New York, New Jersey, Connecticut, Massachusetts, and Florida, The Execu|Search Group specializes in the placement of healthcare professionals in full-time and temporary roles. From Registered Nursing positions to Medical Directors and Hospital Administrators, we work with some of the best healthcare facilities and are focused on connecting candidates with jobs that are tailored to their unique qualifications.  Our Health Services recruiters have achieved the Gold Seal of Approval™ for healthcare staffing services from The Joint Commission, which recognizes our dedication to providing our clients with qualified healthcare professionals.


The Execu|Search Group

CITY :

NEW YORK

STATE :

NY

COUNTRY :

USA

ZIP CODE :

10001

JOB ID NUMBER :

J130854

POSTED :

02/23/2016

Case Management Nurse Manager (RN)


The Execu|Search Group


POSITION TYPE:  Full-Time

JOB SUMMARY:


Case Management Nurse Manager (RN)
Case Management Nurse Manager (RN)
Location: New York, NY
Salary: $81,000-$86,000
Experience: 0.0 year(s)
Job Type: Full-Time
Job ID: J130854
 
   
About the Opportunity

A New York City healthcare organization is currently seeking a licensed Registered Nurse (RN), with a strong Case Management background, for a promising Managerial position with their growing staff. In this role, the Case Management Nurse Manager (RN) will be responsible for effectively managing the daily operations / workflow and supervising clinical and non-clinical staff to provide support for the organization's Care Management programs.

Company Description

Healthcare Organization

Job Description

The Case Management Nurse Manager (RN) will be responsible for:

  • Assisting in developing strategic plan by partnering with Assistant Director and Fund management to identify opportunities that have direct impact on clinical and financial outcomes
  • Accessing and analyzing all processes on an ongoing basis to determine their effectiveness, eliminate inefficiencies and make recommendations to senior management to improve workflow, operations, and staff performance
  • Coordinating activities between clinical programs, communication, and report requirements to maintain operational efficiencies and to be in compliance with the Department of Labor (DOL), Summary Plan Description (SPD) departmental protocols and clinical policies and procedures
  • Interacting and collaborating with other departments (e.g. Claims and Provider Relations) in troubleshooting, problem solving, and exchanging information in conjunction with maintaining effective communication with providers and members
  • Staff development, clinical orientation, ongoing education, and training programs to meet the changing needs of the Department
  • Continually assessing clinical staff performance against internal and external departmental and industry standards
Required Skills
  • 5+ years of Advanced or Specialized work experience in Care Management programs (Utilization / Case Management / Appeals Programs) within a Managed Care organization; 2+ years of progressive Leadership and Management experience
  • Bachelor’s Degree in Nursing, Business or Health Care Administration or equivalent years of work experience required; plus
  • Current NYS Registered Nurse (RN) license
  • Working knowledge of Milliman / InterQual guidelines or other regulatory protocols (i.e. Medicare), claims processing, medical coding (ICD-9, HCPCS, CPT) and interpreting provider contracts
  • Strong Medical / Clinical background
  • Microsoft Office/Suite proficient
  • Solid critical thinking and analytical skills
  • Patient oriented
  • Great interpersonal skills
  • Excellent communication skills (written and verbal)
  • Strong attention to detail
  • Highly organized

$

Desired Skills
  • Previous management experience and CCM certification