Sr. Manager, Case Management, RN (Direct Hire)


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Overview

Company:
Professional Services Network Inc
Job Number:
2798 MD
Department:
Nurse Opportunities
Category:
Direct Hire


Description

We have an immediate need for a Licensed Registered Nurse in the state of Maryland for the position of Senior Manager, Case Management. This position will be contingent upon award by the State, and will require a contingency offer be signed showing intent to take the position once the contract has been awarded.

The position duties include, but are not limited to:

  • Manage department staff, policies, training, and budgets.
  • Utilize clinical review criteria guidelines/tools, such as InterQual for decision making.
  • Conduct precertification, preadmission, concurrent, retrospective, and appeal reviews.
  • Collaborate with management as the lead/liaison and subject matter expert of daily operations.
  • Ensure accreditation, contracts and legal requirements are met and maintained.


Qualification

  • Bachelor’s degree required in related field; Master’s degree preferred
  • Relevant experience and education may be considered
  • 5 years case management, management of licensed clinical staff, and clinical practice work experience
  • Must be familiar with computers, software, and Microsoft suite
  • Ability to perform record reviews
  • Must provide proof of Covid 19 vaccination


Licensure

  • Active, unrestricted current RN license in the state of Maryland
  • Case management certification (CCM) or must be certified within 2 years
  • Certification as an InterQual Instructor (IQCI) or medical management preferred


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