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Staff evaluation, Department redesign and HR education
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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!
Drives clinical quality and safety programs. Responsible for the strategic development, planning and control of health plan and hospital's quality programs and for leading the implementation of compliant programs at the facility, including associated alliance hospitals. Facilitates the development of programs and processes that meet regulatory requirements. Focuses on organization-wide systems and processes for improvement, including clinical quality management, risk management, AR&L and patient safety activities in collaboration with clinical and administrative personnel. Serves as Patient Safety Officer for assigned hospitals. Oversees and facilitates internalization and monitoring of Regional Sub-regional Services. Ensures practitioner review and oversight meets internal standards. Responsible for quality program oversight, associated medical staff issues, member concerns and grievances to ensure submission to accreditation and regulatory bodies are timely and accurate; and ensures that processes supporting submissions are reliable. Facilitates health plan assessment of quality programs at the medical center. Develops strong collaborative leadership relationships with external regulatory agencies, accreditation bodies, employer groups. Has joint accountability to develop systems and corrective action plans for the facility to meet regulatory compliance.
Develop, evaluate, monitor and communicate the long and short term strategic objective of the revenue cycle clincial denials function, ensuring consistency and alignment with the strategic objectives of the centralized revenue cycle organization. Responsible to achieve annual performance goals as established by the Chief Revenue Cycle Office.
Lead a team of RN case managers that will provide continuous audits of all related workflows including but not limited to: risks and risk mitigation, provider and payor compliance, information technology systems (internal and add-ons) and standard operating procedures with an eye towards optimization, automation and timely information exchange between key stake holders to drive performance.
A National non profit hospital is seeking a Supervisor of Utilization Review. In this position you will supervise the implementation of policy and procedures. Current utilization experience along with prior-authorization, status determination, continued stay review and denial management, concurrently and retrospectively is needed. Partnering with the Manager of Utilization Management to identify opportunities for the development, implementation, evaluation, and ongoing revision of initiatives to improve quality, continuity, and cost-effectiveness. Develop and monitor a quality improvement plan for utilization management functions/processes. Provide routine reports to the department Manager.
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.
Do you love to lead teams and inspire caregivers to do their best work every day? Do you enjoy creating efficiency and workflow opportunities? Do you thrive in a collaborative environment with daily operational turn-around times and collaboration with other dynamic leaders? Then we would like to hear from you! We are seeking a Manager of Health Care Services in the prior-authorization department to be responsible for clinical programs, quality care outcomes, and clinical operations in our Utilization Management team.
Working in collaboration with the patient/family/legal representative, social workers, physicians, and interdisciplinary team, the RN case manager is accountable for assessing, coordinating and facilitating patient progression through the continuum of care in an efficient, cost effective manner. The RN Case Manager must achieve this through early assessment of pre-admission level of care, post hospital discharge needs, review of available resource and timely, focused communication with the healthcare team and patient/family/legal representative.
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
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