Medical Management Manager manages the organization's medical management programs, which may include case management, utilization review, quality management, or community health education programs with the goal of providing high quality, cost effective health care services. Collects and analyzes data on utilization, outcomes, safety, and costs to determine trends and identify problem areas. Being a Medical Management Manager presents findings, proposed solutions, and implementation plans to management. Implements long and short term solutions for improvements in patient care and cost savings. Additionally, Medical Management Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Medical Management Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Management Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Location | US-CA-Montclair | ID | 2024-153574 | Category | Clinical Professional | Position Type | Per Diem | Shift | Days | Job Type | Non-Exempt |
Montclair Hospital Medical Center is a 106-bed acute care, not-for-profit community hospital, received the "100 Top Hospital" in the nation award from IBM Watson Health, the Patient Safety Excellence award from Healthgrades, and the Women's Choice Award for America's Best Emergency Care. For more information visit Montclair-hospital.org
At Montclair Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community!
Montclair Hospital Medical Centes is a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to
making a difference.
Our Total Rewards package includes, but is not limited to:
This is a Fast-paced work environment in which you can take pride in serving an underserved community. Come Join a Team of Dedicated Healthcare Workers!!!
Montclair Hospital Medical Center is nationally recognized, locally preferred, and community focused.
We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.
EDUCATION, EXPERIENCE, TRAINING
1. Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.
3. Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred.
4. Current BCLS (AHA) certificate, preferred.
5. Knowledge of Milliman Criteria and InterQual Criteria preferred.
6. Experience and knowledge in basic to intermediate computer skills.
Montclair Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $49.00. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
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