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Manager of Case Management

As the Manager of Case Management, you would assist the Director of Case Management in leading and managing facility-wide utilization management, outside medical service, and coordination of care and discharge planning. A Manager of Case Management would perform duties to conduct and manage the day to day operations of the case management functions communicating with staff to facilitate daily departmental functions.

Education and Experience

  • A current RN certification may be required depending on the specific position
  • Generally, a bachelor’s degree in nursing, health care management, or other related field is required
  • At least a few years of case management experience is required for most positions
  • Familiarity with all Medicaid managed care practices and policies
  • Some prior experience in management of case management may be required depending on the position

Job Duties

  • Appeal denied cases as well as assist physicians with appeals
  • Assists physicians and other hospital personnel in understanding case management issues
  • Works to provide in-house programs as needed for both staff and physicians
  • Directs and coordinates data gathering and record keeping
  • Assists the Director with creating, establishing, and implementing policies, practices, and procedures that are in accordance with all regulatory agencies
  • Takes care of other tasks as assigned by the Director of Case Management