The Nurse Manager of Case Management is responsible for organizing, directing and evaluating the activities of the Case Management Department.

RESPONSIBILITIES:

• Establishes and coordinates utilization and discharge planning functions.
• Coordinates and facilitates multiple resources, internal and external, into a unique and single approach to care coordination for each patient assigned case management services.
• Identifies and implements processes that support and promote efficient patient throughput across the healthcare continuum resulting in optimal clinical outcomes, appropriate utilization of resources, and appropriate and accurate reimbursement.
• Oversees the operations of the referral management, telephonic utilization review, prior authorization, and case management functions.
• Complies with the county, state and federal regulations as it pertains to the Case Management Department.
• Effectively provides ongoing information to Medical Director regarding status of pathways, problems/problem-solving and variation analysis.
• Maintains current knowledge in the field through the review of literature and shares that information as appropriate with staff.
• Quality Metrics and Data Review Analysis.

QUALIFICATIONS / REQUIREMENTS:

Current Licensure in the State of New York as a Registered Nurse. Minimum five years of hospital case management experience preferably in a leadership role; must have clinical (medical) background and understanding of treatment modalities; must be knowledgeable in allied health sciences, appropriate levels of care and the health care delivery system. Medical terminology required, understanding of Medicare criteria and communication skills with ability to discuss patients' clinical courses with physicians at the physician level. Member must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in Hospital. The member must be able to demonstrate the knowledge and skills necessary to mentor members of the case management department.

EDUCATION:

BSN required; Masters Track preferred

OTHER:

The individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials

About Us:

Bon Secours Community Hospital

For nearly a century, Bon Secours Community Hospital in Port Jervis, NY, has served the residents of western Orange County, NY, Pike County, PA, and northern Sussex County, NJ, as the area's premier healthcare provider. The hospital serves its community with 122 beds for acute care and medical-surgical services, a 24-hour emergency department, long-term care and rehabilitation, a dedicated bariatric surgery unit, behavioral health, and outpatient services.