Manager Care Coordination - SFL

M1038MAY08

Job duties include but are not limited to the following:
* Responsible for managing the day-to-day operations of an integrated Care Coordination unit including Concurrent Review, Discharge Planning and Case Management nurses.
* Ensure that appropriate training, coaching and mentoring is effectively implemented in a team environment.
* Responsible for building relationships with regional facilities, meeting with their care staff to ensure a collaborative working environment to the benefit of our members.
* Be knowledgeable of each of the regional hospital contracts and customized requirements for care coordination. Have a working knowledge of all lines of business and its care coordination capabilities.

Job Requirements:
* Bachelor’s degree in a related field or equivalent experience
* Current active Florida RN license
* 5 or more years directly related work experience defined as 3+ years of a combination of clinical and managed care experience including 2 or more years direct supervisory experience to include concurrent reviewer/discharge planner or case manager. experience
* Leader by example, setting clear actionable goals in a team environment.
* Effectively work in a group/team leadership role
* Experience in continuous quality improvement initiatives
* Experience working with MS Word and Excel
* 10-20% travel

Business Specific Criteria (preferred skills):
* Utilization Review knowledge with InterQual
* Experience working with CMCS or CCMS systems
* Experience working at the intermediate level with MS Word and Excel
* Bachelor’s degree in related field
* BCBS system experience