Manager, Inpatient Case Management Afterhours (RN)

Job description

Position Summary: Reporting to the Senior Director of Case Management, this position is directly responsible for managing the daily operations of inpatient case management across Regal Medical Group. The Manager, Inpatient Case Management is responsible for oversight of inpatient review, concurrent review and discharge planning of inpatient cases for all members assigned to this region. Responsible for the development of concurrent review and discharge planning training and quality review programs that maximize quality while utilizing appropriate resources within the members’ benefit plans and established contracts. The Manager will also be responsible for cooperation and problem solving with network management, finance, and claims department. The manager is expected to work in collaboration with other medical management departments to ensure optimal clinical outcomes, appropriate resource utilization, quality patient care, and high enrollee satisfaction. The manager will participate in process improvement measures such as standardized documentation and auditing, programs that maximize quality, and programs to ensure appropriate resource utilization within members benefit plan and...