Director, Case Management
The Director, Case Management coordinates and administers organization programs for utilization review and case management; ensures compliance with The Joint Commission (TJC), New York State Department of Health (NYSDOH), Center for Medicare and Medicaid Services (CMS) and other regulatory agencies as they apply to the organization utilization and case management programs, including development of necessary policies.
Applicants must have a License to practice as a Registered Nurse in the State of New York and a Bachelor’s degree in nursing and the equivalent of five years of full-time experience in case management or a related field, including two years experience in a supervisory, administrative, consultative, managerial or executive capacity. The preferred candidate will have a Master’s degree, Certification in case management (CCM), three years of hospital-based case management experience, including utilization review and discharge planning, and experience with oversight of patient placement and denials management/appeals. They will also have a working knowledge of the insurance industry, and federal, state and local regulations as it relates to utilization review and discharge planning and demonstrated ability to develop and implement strategic plans and process improvement measures. They will be proficient in Microsoft Office, will have excellent written and oral communication skills and exceptional interpersonal and leadership skills. They will also have a strong work ethic and focus on customer service, the ability to work in a team environment and excellent organizational and problem solving skills.
Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at firstname.lastname@example.org.