CARE COORDINATION MANAGER
Charlotte, NC
$100-150K+ Annual Incentive Opportunity + Full Benefits.
The Care Coordination Manager is responsible for overseeing and coordinating care coordination activities at our Medical Center location in Charlotte, NC. In this role, you will work closely with the medical staff and Medical Center leadership to identify patient care trends and issues and develop care management programs that ensure efficient use of medical resources while providing high-quality, cost-effective care.
Qualifications
This position requires proficiency in working with medical statistics and data, including databases. Experience with medical statistical process and control procedures is required. The Care Coordination Manager must possess excellent written and verbal communication skills and demonstrate the ability to prepare statistical data and reports for formal presentations. Additionally, the successful candidate must be able to effectively interact with individuals who possess diverse personalities and levels of professional expertise.
Education:
Required: Bachelor's degree in Nursing or Health Care Administration for RN or master's in social work for MSW
Preferred: MSN, MBA, MSW, or MHA
Certifications:
Required: Registered Nurse or LCSW/LMSW license. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN or LCSW/LMSW license for state(s) covered.
Preferred: Accredited Case Manager (ACM)
Experience:
Five to seven years of experience with utilization review, clinical pathways, case management, and disease management are required. Supervisory experience is preferred.
Responsibilities
The Care Coordination Manager will be responsible for the following:
- Managing department operations to ensure effective patient throughput and reimbursement for services provided
- Leading the implementation and oversight of the hospital Utilization Management Plan to improve hospital utilization performance
- Ensuring compliance with medical necessity and revenue cycle processes in accordance with CMS regulations and hospital policies
- Facilitating timely and effective patient transition and planning to support efficient patient throughput
- Implementing and monitoring processes to prevent payer disputes
- Developing and delivering physician education and feedback on hospital utilization
- Participating in the management of the post-acute provider network
- Ensuring compliance with state and federal regulations and TJC accreditation standards
Experience:
Required: 3 years of acute hospital case management or healthcare leadership experience
Preferred: 5 years of acute hospital case management leadership multi-site experience