Job Summary: Directs and oversees the operations of Sinai Care Management services. Plans, organizes, implements, and evaluates delivery of care management and discharge planning to ensure appropriate utilization management thereby minimizing denials and appeals. Collaborates with Manager of Utilization/Denials and Appeals program to reduce denials and optimize utilization activities. Assures that care is facilitated, coordinated and integrated across the continuum in order to assure and enhance patient and family engagement; Assures that care coordination is outcomes focused and is managed in a cost effective manner to decrease length of stay and manage readmissions.
Requirements: 5-7 years of experience; Nursing degree and Masters in Health Administration, Business Administration, or related field. Certified Case Manager and/or Accredited Case Manager in good standing. Seasoned professional knowledge; equivalent to a Master's degree; knowledge in more than one discipline