Manager Care Management Service

Registered Nurse license issued by the state in which the team member practices
Social Worker license issued by the state in which the team member practices
Bachelor’s Degree in Nursing or Master’s Degree in Social Work
Typically requires 5 years of experience in a relevant clinical setting
Includes 1 year of supervisory experience in a Care Management Leadership role
Ability to prioritize and organize work
Ability to travel and work across multiple sites as assigned (IL or WI)
Effective communication skills
Utilization of critical thinking in timely decision making
Knowledge of MS Office products
Demonstrates leadership skills
Knowledge of Medicare A and B guidelines
Knowledge of Managed Care programs/requirements/implications
Knowledge of Conditions of Participation for Discharge Planning
Knowledge of requirement elements of Utilization Management program, including support of the UM Plan
Knowledge of Regulatory environment
Ability to work autonomously and respond to multiple requests effectively

Provides management oversight of the daily operations of the care management and social work programs at the assigned site(s)
Facilitates performance improvement activities for the care management program
Identifies and discusses overall and individual physician trends related to care management activities
Serves as an internal consultant on Care Management opportunities
Accountable for site care management/social work budgets as assigned
Ensures the care management/social work program operates within compliance of CMS, OSHA, Accrediting Organizations, and established care management practice standards and code of ethics
Responsible for orientation, and ongoing competency assessment of CM/SW staff
Responsible for personal professional growth
Performs human resources responsibilities for staff

Master of Nursing Administration, Master in Health Care Administration or related field preferred