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Company: Sarasota Memorial Health Care System
Location: Sarasota
Posted on: May 3, 2021

Job Description:

This dynamic leader utilizes a systems approach in planning, creating strategies, developing programs that address case management functions across the transitions of care, and directing the activities of the Integrated Case Management department. The Director develops, implements, coordinates and monitors the hospital's case management, utilization management, discharge planning and social work functions to assure current best practice standards and compliance with Federal, State and regulatory agency requirements. The Director works collaboratively to provide consultation and assistance regarding medical, social, legal and ethical situations needing intervention. The Director possesses knowledge in key functions of revenue cycle, denial management and related payer contract requirements. The Director manages, organizes, and co-facilitates the UR Committee with the Medical Director of Integrated Case Management per the UR Plan and the Conditions of Participation. The Director sets the tone and models positive leadership behavior in support of staff, and towards achieving department and organizational goals. In addition to building relationships with internal stakeholders, this leader will develop partnerships with post-acute facilities and agencies to meet the needs of SMH patient population.

- Require a Bachelors degree in nursing, clinical or business area, or in health care administration.

- Require a minimum of seven (7) years of experience in case management, care coordination and utilization management with a minimum of three (3) to five (5) years of progressive leadership and management experience preferably in a director role in a hospital setting.

- Prefer Masters degree in related clinical or business area, or in health care administration.

- Prefer active membership in professional organizations and relevant professional certifications (i.e., CCM, CMAC, or ACM).

- Prefer demonstrated ability to interact and interface with all levels of staff, senior management and members of the medical staff.

- Prefer demonstrated ability to work independently and in groups toward established objectives.

- Prefer demonstrated effective leadership, critical thinking, decision making and problem solving skills.

- Prefer demonstrated excellent oral, written communication and presentation skills, including proficiency in Microsoft Office programs.

- Prefer demonstrated working knowledge of utilization management and the application of evidenced based clinical care guidelines.

- Prefer sound working knowledge of relevant CMS Rules and Regulations, Joint Commission standards and State and Payer requirements.

- Prefer strong data analytical and management reporting skills.

Keywords: Sarasota Memorial Health Care System, Sarasota , Director, Other , Sarasota, Florida

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