Manager - Case Management (Sunrise Children's)
Serving the community for nearly 60 years, Sunrise Hospital & Medical Center provides Las Vegas and the Southwest region with high quality, advanced healthcare services. Sunrise Hospital is the largest acute care facility in Nevada. Sharing the same campus as Sunrise Children's Hospital, Nevada's largest most comprehensive children's hospital.
The Manager of Case Management will assist in the direction of the Case Management program, including the functions of case management, utilization management, resource management, discharge planning and care coordination for the facility. The Manager of Case Management is responsible for assisting in the coordination of the systems necessary for safe and appropriate discharges as well as utilization management practices that meet corporate, division, facility and regulatory guidelines. The Manager of Case Management will assess and evaluate the care/services provided, staffing levels, competency and educational needs of the case management staff and effectively coordinates and controls resources. The Manager of Case Management provides consultation and education to facility leadership, clinical and financial personnel, the Board of Trustees, and medical staff members related to case management practices. The position assists the Administrative Director of Case Management who oversees the annual review of the Case Management/Utilization Review Plan of the hospital. The position will assist in the identification and implementation of processes that support and promote efficient patient throughput across the Healthcare Continuum resulting in optimal clinical outcomes, appropriate utilization of resources, appropriate patient status, level of care and appropriate and accurate reimbursement.
Education: Minimum: Diploma in Nursing, ADN, BA or BSN degree in nursing or other healthcare related field.
(Master's degree preferred)
Preferred: National Certification in Case Management (ACM or CCM)
Minimum 3 years experience in case management in the acute setting, and potential for progressive management levels working in the area of case management and utilization review.
Excellent communication skills, positive attitude with excellent customer service skills. Advanced knowledge of levels of care criteria; strong leadership skills. Good financial management. Strong knowledge of regulatory standards for federal payers, JCAHO, and other insurance companies.
Maintain professional licensure as appropriate to discipline.