Lead Case Manager
Gallipolis, OHJobPosted 4mo agoSeen in employer's feed 5 days ago
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Job overview
Holzer Health System is hiring a Lead Case Manager. The Lead Case Manager supervises case managers daily, ensuring quality and timely services while meeting program objectives. This role involves resolving conflicts with participants, reviewing medical records for admissions and continued stays, and monitoring resource utilization. The Lead Case Manager collaborates with a multidisciplinary team to improve clinical care, customer satisfaction, and organizational outcomes, serving as a clinical expert in Utilization Review and Case Management.
Key focus areas include Supervise case managers on a day to day basis, Oversee performance of case managers to ensure quality and timely services, and Resolve conflicts that arise with participants and failure to comply issues.
Successful candidates bring Graduate Of An Accredited School Of Nursing, Active RN License Recognized By The Ohio Board Of Nursing, and Past Utilization Review And Case Management Experience. Important skills include Supervising Case Managers, Conflict Resolution, Medical Record Review, Utilization Review, Case Management, and Multidisciplinary Team Collaboration.
Skills & qualifications
Skills
Qualifications
Full job description
Works under the supervision of the Director of Care Management. Supervises case managers on a day to day basis. Oversees performance of case managers to ensure that participants receive quality and timely services and that program objectives are met. Resolve conflicts that arise with participants and failure to comply issues. Reviews the medical record on a concurrent basis, utilizing criteria accepted and approved by the Medical Staff, for admissions and continued stay of patients requiring acute care or observation. Monitors the plan of care to ensure the efficient utilization of resources. Collaborates with the multidisciplinary team to improve clinical care, customer satisfaction, organizational and financial outcomes. Serves as a clinical expert and resource in Utilization Review and Case Management. Refers potential candidates for early discharge planning to Social Work, Hospice, Home Health or Rehab as appropriate to help facilitate transitions in care. Responsible for reviewing every hospital patient account for correct status and billing compliance. Assists with Performance Improvement monitoring and reporting activities. Performs other duties as assigned.
Education, Work Experience and Licensure:
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Graduate of an accredited school of nursing. BSN preferred
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Active RN license recognized by the Ohio Board of Nursing
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Past Utilization Review and Case Management experience required
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Certification in Case Management recommended
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