IMM Case manager will organize services across provider lines, between people and systems, to effect optimal patient outcomes, achieve continuity and quality of care and reduce costs.
Bachelors degree in Nursing, Business, or Health related field preferred. RN license required. Five years experience in clinical nursing. A minimum of two years of recent experience in acute clinical, utilization review, or case management within the last 10 years. National certification preferred within 3 years of hire. Computer knowledge to include Windows, Word, Excel, and database systems. Ability to analyze trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit analysis, negotiation, & cost containment. Knowledge of regulatory requirements inclusive of NCQA, CMS, JCAHO, DOI, HSD. Knowledge in referral coordination to community & private/public resources.
Requires detailed knowledge of utilization management principles and cost-effective coordination of care in terms of what and how work is to be done as well as why it is done, this level includes interpretation of data.
Mental Power:Ability to make decisions that require significant analysis and investigation with solutions requiring significant original thinking.
Mental Power:Ability to determine appropriate courses of action in more complex situations that may not be addressed by existing policies, procedures or protocols. Decisions include such matters as critical thinking, order in which work is done, and application of established procedures.
Physical Power:Walks, sits, stands in place, arm/wrist/hand movement, lifts.
Driving; sitting at computer; using laptop.
Enjoy a competitive compensation and benefits package, a supportive working environment, and a stable employer who is dedicated to providing the support and resources critical to giving the highest quality of care. Please review qualifications and full job description at www.phs.org . Questions? Call 505-823-8756. PHS is committed to ensuring a drug-free workplace. EOE