Manager, Health Care Management, UR position at The Job Junction in Overland Park

The Job Junction is at present recruited Manager, Health Care Management, UR on Sun, 17 Nov 2013 23:38:32 GMT. RNs only, please. Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent review to ensure cost effective care management, utilization of health, mental health, and substance abuse services. Responsibilities: 1. Manages and oversees teams responsible for various HCMS functions including utilization management, case...

Manager, Health Care Management, UR

Location: Overland Park Kansas

Description: The Job Junction is at present recruited Manager, Health Care Management, UR right now, this position will be placed in Kansas. Detailed specification about this position opportunity kindly see the descriptions. RNs only, please.

Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent revie! w to ensure cost effective care management, utilization of health, mental health, and substance abuse services.

Responsibilities:
1. Manages and oversees teams responsible for various HCMS functions including utilization management, case finding and coordinating those cases that involve co-morbid conditions and need to be part of the case management/disease management track.
2. Responsible for coordination and service delivery to include member assessment of physical and psychological factors.
3. Works with providers to establish short and long term goals that meet the member’s need, functional abilities and referral sources requirements.
4. Communicates care plan objectives utilizing community resources to individuals, departments, and providers identified as having a role in the care of members.
5. Coordinates the identifications of members with potential for high risk complications; assesses members’ present level of physical/menta! l impairment utilizing defined criteria and methodology.
6! . Demonstrates understanding of the physical and psychological characteristics of illness, disabilities and wellness and makes referrals when appropriate.
7. Review benefit systems and cost benefit analysis.
8. Evaluates the member against level of care criteria.
9. Acquires data and evaluates necessary medical, mental health and substance abuse service for cost containment.
10. Perform other duties as assigned.

Qualifications:
EDUCATION AND EXPERIENCE
Education

Required:

• Nursing Diploma or Associate’s Degree in related Nursing.

Preferred:

• Bachelor’s Degree in related Nursing or Master’s Degree in related Health/Nursing field.

Years and Type of Experience

Required:

• Minimum of five years experience in health Care Management and at least one year of leadership/management experience.

Certifications or Licensures

Required:

• RN, PA, NP
• Behavioral Health may also have LMSP in addition to any of the above.

Preferred:

• Certified Case Manager or Certified Utilization Review Professional.

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If you were eligible to this position, please email us your resume, with salary requirements and a resume to The Job Junction.

If you interested on this position just click on the Apply button, you will be redirected to the official website

This position starts available on: Sun, 17 Nov 2013 23:38:32 GMT

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