Case Management Director jobs in Passaic, NJ

Case Management Director oversees a staff of case managers responsible for patient care coordination. Develops and implements case management programs, including utilization review, intake or discharge planning, and managed care contracting or negotiation. Being a Case Management Director evaluates patient care data to ensure that care is provided in accordance with clinical guidelines and organizational standards. Seeks treatments that balance clinical and financial concerns with the family's needs and the patient's quality of life. Additionally, Case Management Director contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care. Typically requires a bachelor's degree. Typically reports to top management. May require Registered Nurse (RN). The Case Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Case Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Manager-Case Management
  • Arbor Glen Center
  • Cedar Grove, NJ FULL_TIME
  • The Manager, Case Management is responsible for the clinical, administrative, and financial oversight of the territory's center-based care management staff. This position oversees the personnel and processes necessary to ensure that the territory's network of owned and managed centers is effectively managing resource utilization, improving clinical outcomes, maximizing reimbursement, complying with contractual obligations and responding to the needs of its payor customers. The Manager will also perform the functions of the Case Management Job Description and will be measured based on case management productivity standards. RESPONSIBILITIES/ACCOUNTABILITIES: 1. Under the direction of the Director or Sr. Director, assists with the development, implementation, and maintenance of a case management model which meets the clinical and financial goals of Genesis and the operational expectations of Genesis' payor customers 2. Identifies business development opportunities which result (or may result) in improved center specific clinical and administrative capabilities and communicates them upward. 3. Develops systems which measure the utilization of services in assigned centers, identifies opportunities for improvement, provides feedback to management and assure systems in place to interface with financial and clinical outcomes. 4. In collaboration with the Director or Sr. Director, develops a formal procedure for effectively addressing concurrent and retrospective clinical and administrative denials by payors and trains staff on same. 5. Manages relationships with third party payors by ensuring timely responses to requests and by anticipating their needs with respect to each patient's course of stay. 6. Establishes standards of performance and productivity benchmarks for case management staff and ensures they are met through consistent, accurate work processes and census tracking/ monitoring. 7. Supervises, monitors and evaluates assigned staff. Oversees, evaluates, and completes performance appraisal for assigned staff. May participate in hiring of new staff under the direction of the Director or Sr. Director. 8. Identifies staff training needs related to managed care contracts and collaborates with appropriate Genesis personnel to develop the educational tools and materials that are needed to achieve care management goals. 9. Works collaboratively with the Director or Sr. Director of Case Management to update strategic business plan and ensure deadlines and goals are met. 10. In conjunction with the Director or Sr. Director, acts as case management interface with other area and corporate departments as well as external customers as needed 11. Acts as resource to staff for questions or issues in daily workflow. 12. Assist staff to secure authorizations for applicable exclusions defined by contract or obtains exception approvals for high cost medications and/or equipment. Assure exclusions are properly documented in Collections Module and communication provided to vendor when billing plan directly. 13. Provides coverage plan for team members approved or unexpected time off. 14. Works with Team Members and Revenue Cycle Management Team to reduce AR/DSO and outstanding clinical accounts as needed and generates clinical appeals when necessary. 15. Assists with and completes special projects as assigned MCM1
    Qualifications: SPECIFIC EDUCATIONAL/VOCATIONAL REQUIREMENTS: 1. Graduate of an accredited School of Nursing with current RN licensure in the state where employment occurs is required. Bachelor's Degree in Nursing preferred. Certified Case Management (CCM) or related clinical certification also preferred.2. Five to seven years of clinical nursing experience is required. Prior experience in utilization review, case management or discharge planning is required. Prior experience using evidence-based clinical decision support criteria (e.g. Interqual, Milliman) is required.3. Experience in rehabilitation nursing, acute care and/or the insurance field preferred. Five years plus full time experience in case management which includes service to short/long term facility based clients preferred.4. Management experience leading teams, groups and/or department preferred. Experience managing virtual teams a plus.5. Valid driver's license and automobile with appropriate insurance required. Ability to travel if needed. 6. Ability to adjust work schedule to changing business needs of the department.
    Position Type: Part Time
    Requisition Number: 429388

    Pay Target:
    BSN Preferred

    Five-Plus Years
  • 5 Days Ago

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Hospice RN Case Manager
  • Affinity Hospice Management LLC
  • Passaic, NJ FULL_TIME
  • JOB DESCRIPTION SUMMARY The registered nurse plans, organizes and directs hospice care and is experienced in nursing, with emphasis on community health education/experience. The professional nurse bui...
  • 11 Days Ago

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Director, Contract Management
  • MHA
  • Parsippany, NJ FULL_TIME
  • Managed Health Care Associates, Inc. (MHA) is a leading health care services and technology company that offers a growing portfolio of services and solutions to support the diverse and complex needs o...
  • 12 Days Ago

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Director Account Management
  • Teva Pharmaceuticals
  • Parsippany, NJ FULL_TIME
  • Apply now » Director Account Management Date: Apr 10, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 55281 Who we are Together, we’re on a mission to...
  • 6 Days Ago

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Director of Admissios
  • Complete Care Management
  • Passaic, NJ FULL_TIME
  • NOW HIRING: DIRECTOR OF ADMISSIONS GREAT BENEFITS! GREAT RATES! GREAT ENVIRONMENT Complete Care at Hamilton Plaza cchamiltonplaza.com 56 Hamilton Ave, Passaic, NJ 07055 (973) 773-7070 NOW HIRING: DIRE...
  • 21 Days Ago

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Admissions Director
  • Complete Care Management
  • Cedar Grove, NJ FULL_TIME
  • Outragous Wage! Apply with Confidence! Share your talent. Feel recognized and appreciate. Join our team. UNDER NEW MANAGEMENT! APPLY FOR GREAT NEW PERKS!!! Complete Care at Cedar Grove536 Ridge RoadCe...
  • 2 Months Ago

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0 Case Management Director jobs found in Passaic, NJ area

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Managing Director / Senior Managing Director - Debt Advisory
  • Oberon Securities, LLC
  • New York, NY
  • Oberon Securities, based in New York City, is seeking experienced Managing Directors with expertise raising asset, cash ...
  • 4/19/2024 12:00:00 AM

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Managing Director
  • FinPro, Inc.
  • Somerville, NJ
  • FinPro is a dynamic nearly four decade old bank consulting, investment banking and data analytics firm located in Somerv...
  • 4/19/2024 12:00:00 AM

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Managing Director
  • REUVENI Development Marketing
  • New York, NY
  • Reuveni is seeking a Managing Director. Reuveni Development Marketing (d/b/a Reuveni LLC) is a privately owned and opera...
  • 4/18/2024 12:00:00 AM

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Relationship Management Director
  • DTCC Digital Assets
  • Jersey City, NJ
  • Are you ready to make an impact at DTCC? Do you want to work on innovative projects, collaborate with a dynamic and supp...
  • 4/18/2024 12:00:00 AM

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Managing Director in Cybersecurity
  • Sia Partners
  • New York, NY
  • Sia Partners is a next-generation management consulting firm. We offer a unique blend of AI and design capabilities, aug...
  • 4/17/2024 12:00:00 AM

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Managing Director in Insurance
  • Sia Partners
  • New York, NY
  • Sia Partners is a next-generation management consulting firm. We offer a unique blend of AI and design capabilities, aug...
  • 4/17/2024 12:00:00 AM

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Managing Director, Product Management
  • Omnicom Media Group
  • New York, NY
  • Overview Job Description Annalect's 2,000+ innovators leverage data and technology to help clients across Omnicom build ...
  • 4/16/2024 12:00:00 AM

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HR Manager Director
  • Project Redirect Inc Of The Distric
  • New York, NY
  • Job Description Job Description A non-profit social services organization operating family shelters throughout NYC. Thes...
  • 4/16/2024 12:00:00 AM

According to the United States Census Bureau, the city had a total area of 3.244 square miles (8.401 km2), including 3.146 square miles (8.149 km2) of land and 0.098 square miles (0.253 km2) of water (3.01%). Unincorporated communities, localities and place names located partially or completely within the city include Davis Bridge and Pleasant Plains. Passaic's only land border is with neighboring Clifton, which borders Passaic to the north, south, and west. The Passaic River forms the eastern border of Passaic. Four additional neighboring towns in Bergen County immediately across the river fr...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Case Management Director jobs
$173,402 to $243,505
Passaic, New Jersey area prices
were up 1.5% from a year ago

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