Manages Case Management Department (includes Bed Board/Clinical Intake, Disease Management, Social Services, Discharge Planning, Precertification and Denial management; plans, organizes, and directs all related functions and activities (internal and external); establishes goals, objectives, standards of performance; develops operating policies and procedures; interprets hospital policies, standards and regulations to appropriate staff, patients, medical staff and public.
Evaluates the effectiveness of Case Management services related to reimbursement for inpatient and outpatient services. Coordinates, negotiates, procures services and resources for the management the care of complex patients to facilitate achievement of quality and cost efficient patient outcomes. Looks for opportunities to reduce cost while ensuring the highest quality of care is maintained. Develops clinically based case management, discharge planning, and care coordination to facilitate the delivery of cost-effective quality healthcare through identification of appropriate utilization of resources across the continuum of care.

FLSA: Exempt
EEO: X 01 Officials and Managers □ 02 Professionals □ 03 Technicians □ 04 Sales Workers □ 05 Administrative Support Workers □ 06 Craft Workers □ 07 Operatives □ 08 Laborers and Helpers □ 09 Service Workers

Minimum Education
-Bachelor's degree or 8 years or more of relevant Case Management experience -Required
-Graduate of a Bachelor's Program in Nursing or must complete within 18 months upon date of hire -Required
-Master's degree or 10 years or more of relevant Case Management experience -Preferred

Required Skills
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

Licenses
Professional Registered Nursing licensure in state of GA.

Minimum Work Experience
Five (5) years clinical experience preferred

About St. Francis-Emory Healthcare

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