Job Description:

Full Time 40 weekly hours, day shift

Job Summary:

The manager is responsible for the overall development and management of the Cooperative Care Program.

Principal Duties and Responsibilities:

The following is a summary of the major functions of this individual's job. He or she may perform other duties, both major and minor, which are not mentioned below, and specific functions may change from time to time.

Develops and continuously evaluates the Cooperative Care Program for cost-effective, quality outcomes. Implements changes as needed.

2. Maintains knowledge of current and future trends in the health care environment, including a working knowledge of payer's policies and requirements.

3. Responsible for the utilization management activities of the department.

4. Develops effective relationships with physicians, corporate leadership and all other parties who routinely interact with the case management department.

5. Attends designated medical staff meetings.

6. Ensures accuracy of all data gathered and analyzed in the department.

7. Serves as a hospital liaison to third party payers.

8. Identifies practice patterns that can lead to quality and utilization improvement in conjunction with physician advisor and medical director.

9. Facilitates compliance with regulatory agency standards.

10. Assists with preparation and compliance of annual capital, expense and FTE budgets.

11. Participates in recruitment/retention efforts; interviewing/hiring of new staff and evaluating performance of Cooperative Care Program staff.

12. Responsible for supporting and utilizing the concepts of quality performance improvement.

13. Provides leadership and serves as a professional resource to ensure development of excellence within the department.

14. Develops staff and patient education and orientation programs related to CCP functions.

15. Exhibits creativity to devise new approaches for complex, novel or previously unsolved problems.

16. Demonstrates diplomatic interactions with internal and external customers.

17. Facilitates good communication with employees.

18. Completes administrative function in the absence of the director.

19. Maintains confidentiality of patient and physician related information.

Minimum Education, Training and Experience Required:

A. Active Kentucky RN license required.

B. Minimum of five years clinical experience and five years of case management experience.

C. CCM required.

D. Previous management experience required.