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Staff evaluation, Department redesign and HR education
Contract to Hire!
Global Care Management is an all-female owned (click below to learn more about us!) boutique style agency that brings 35+ years of combined experience in health care recruitment. Specialists in the world of Care Management staffing and consulting, which also includes Utilization Management, Quality Improvement, Appeals and Denials as well as Physician Advisors and CMO’s. We have successfully led HEDIS projects and the redesign of care management departments.
We partner with our clients in the search for the best candidates for critical open jobs under the umbrella of Care Management, enabling them to maximize the balance of patient and financial needs, for better overall outcomes.
In collaboration with key executives, Global Care Management offers a comprehensive evaluation of their Care Management team/department and recommendations to achieve employee satisfaction and better patient outcomes.
Recruitment Process Outsourcing:
Give your valued Human Resources team a break, enabling them to focus on other crucial HR activities, and let us support them by handling Care Management recruitment. We are not here to replace your HR team… in fact, our approach is quite the opposite. Our services are designed to come alongside and collaborate with HR, working together to achieve the organization’s critical hiring needs. We can offer our clients full or partial RPO services. Our primary goal is to source the very best candidates who will help our clients achieve better patient outcomes.
Looking for a job, is a full time job! With over thirty years experience, we know how to listen. We are interested in your skills and career goals and matching you with the best opportunity.
We work with employers that you will want to work for based on reputation, environment, stability, internal growth and uniqueness within health care. Success for us is not just finding stellar candidates, it’s finding outstanding employers for those stellar candidates. We are focused and familiar with both candidates and clients, enabling us to make the best possible match for both sides.
Let us do the work in your next search!
PRINCIPLE DUTIES AND RESPONSIBILITIES
• Continually assesses processes and effectiveness of Case Management/Discharge Planning functions
• Selects and supervises unit staff
• Monitors and evaluates staff performance/competency on an ongoing basis and in collaboration with the employee:
o Recognizes employee’s strengths
o Coaches up
o Identifies employee’s work-related needs and goals
• In collaboration with unit staff and Clinical & Professional Development staff, identifies and develops plans to address staff learning/competency improvement needs
• Acts as a clinical resource for staff
• Develops department-specific policies, procedures, and clinical competencies using evidence based standards of care
• Prepares and monitors unit budget(s)/productivity. Identifies cost-effective systems needed to support the business of the department, taking into account business trends, resource availability, and changes in patient mix
• Interacts with patients, seeks staff input, and analyzes unit patient satisfaction data to identify areas for improvement
• Ensures unit performance conforms with hospital-wide quality and patient safety goals
• Develops, monitors, and evaluates unit-specific quality improvement indicators, in collaboration with Quality Division
• Develops and maintains effective working relationships with unit co-workers, physicians, vendors, other departments and members of the healthcare team
• Collaborates with CQO and other managers to assess overall staffing patterns and the need for RN contract services
The Denials Management Appeals Nurse is responsible for managing medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Denials Management Appeals Nurse will utilize their clinical background to address the clinical denials. The Denial Management Appeals Nurse will write sound, compelling factual arguments for appealing denials.
The Denials Management Appeals Nurse is responsible for maintaining a detailed knowledge of Third Party Payors and Governmental Payors clinical/medical necessity criteria, as well as for filing compliant appeals in accordance with Third party and governmental contracts.
The Manager of Care Management requires a thorough understanding of clinical, financial, administrative, and psychosocial components of case management. Directs and supervises the operation and activities of the case Management department, including Utilization review, social services and discharge planning. Responsible for the overall management of the department’s daily operations to achieve quality improvement, fiscal productivity, and patient satisfaction goals. Responsible for staff performance and the accomplishment of departmental responsibilities in accordance with the hospital, the department and regulatory requirements. Responsible for the efficient operation of the department and optimum use of resources to maximize productivity and minimize costs.
Leads the development of a shared vision for the next evolution of IT solutions for Continuing Care. Develops the strategic plan and works with stakeholders to set and achieve strategic goals technology solution goals. Functions as Health Care Informatics lead. Develops implementation plans in collaboration with company’s leaders. Responsibilities include analysis of business requirements, workflow, application testing and implementation of new systems.
Keeps abreast of current technology trends to support programs. Overall accountability for home health, hospice clinical service and clinical quality. Objectives are achieved by ensuring full regulatory compliance for home health and hospice services, ensuring that the services and clinical quality are met. Develops and coordinates the home health and hospice quality plan across the service line and ensures continuous improvement in service and clinical quality. Oversees the performance of all clinical nurse specialists and quality coordinators across the service line and is responsible for the creation of standard work for service line and branch specific clinical nurse specialists to include the development of service line orientation programs and branch specific educational opportunities and skills and competency development of staff. Ensures the integration of service and clinical quality, compliance with home health and hospice business operations.
As a Licensed Vocational Nurse Supervisor, you will be responsible for performing moderately complex and/or specialized patient-oriented procedures under the supervision of a clinician or Registered Nurse (RN) to ensure that patients receive appropriate care. Responsible for performing operational duties as required under the supervision of the site administrator or designee.
What Work Will Look Like:
We have other positions not listed - please call for more information
Too many times the words supported, participated, help, review, insure, demonstrated is used instead of using a Power Words that truly describes the action taken.
A resume is your time to your shine, boast and brag. Below is a list of Power Words, please use them in your resume and be proud!
Advised Advocated Edited Accelerated Achieved Administered Advanced Aligned Analyzed Assembled Attained Audited Authored Awarded Boosted Briefed Built Calculated Capitalized Centralized Chaired Charted Clarified Co-authored Completed Composed Conserved Consolidated Consulted Controlled Converted Coordinated Counseled Created Cultivated Customized Decreased Defined Delivered Designed Developed Devised Directed Earned Educated Engineered Enhanced Established Examined Exceeded Executed Expanded Expedited Explored Facilitated Fielded Forecasted Formalized Formed Formulated Founded Furthered Gained Generated Guided Headed Hired Identified Illustrated Implemented Improved Incorporated Informed Initiated Instituted Integrated Interpreted Introduced Investigated Launched Lobbied Mapped Maximized Measured Mentored Merged Mobilized Modified Motivated Operated Orchestrated Organized Outpaced Outperformed Overhauled Pioneered Planned Produced Programmed Promoted Qualified Quantified Reconciled Redesigned Refined Refocused Remodeled Reorganized Replaced Resolved Restructured Revamped Reviewed Showcased Simplified Spearheaded Standardized Streamlined Strengthened Succeeded Supervised Surpassed Sustained Targeted Tested Tracked Trained Transformed Unified United Updated Upgraded Yielded
We look forward to working with you!
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