Director - Inpatient Care Management

Roanoke, VA, US, 24014

Job Summary

Step up and join the extraordinary nurses providing extraordinary care at Carilion Clinic, a Joint Commission-accredited network that includes seven hospitals, two of which are Magnet®-designated; multi-specialty physician practices; and affiliations with prestigious academic medical institutions.
 
A regional leader based in Roanoke, Virginia, we have been honored with the Beacon Award, recognized for renowned nursing research, and nationally ranked in U.S. News & World Report. Realize the advantages of advancing your career with an organization where you can expect supportive leadership, shared decision-making, state-of-the-art technological resources, inter-professional teamwork, and innovative learning.
 

Directs CMC's Case Management, and Utilization Management departments . Supports a collaborative and coordinated process with nursing, ancillary departments and physicians to ensure the effective utilization of clinical resources leading to quality, cost effective patient care across the health care continuum. Supervises and coordinates employees engaged in these activities to manage the resources and costs of high-risk or high-cost cases. Identifies appropriate cost-effective methods to manage high-risk, high-cost diagnoses and care plans. Collaborates with Carilion’s ambulatory practices as well as external post-acute providers.  Assures productivity and financial goals are met, through utilization review processes, length of stay initiatives and denial management.

 

Responsible for leading a high performance team of organizational thinkers who routinely incorporate sound leadership principles in performing the functions of case management, utilization review, and social work service.

 

Directs multiple functions.  Routinely communicates and interacts with all levels of the health care and administrative staff. Acts as a liaison between Carilion and a multitude of community agencies including payors, the Virginia Department of Health and multiple community service agencies. Job functions directly impact reimbursement and net revenue for Carilion.

 

Operates in a complex and stressful environment, often dealing with life and death situations, fast-paced environment with multiple priorities.  Patient environment requires maintaining privacy and confidentiality of information.

Minimum Qualifications

Education: Bachelors Degree in Nursing required.  Masters degree required in a health care or business field.

 

Experience: Five years management experience in a clinical health care setting, with responsibilities for clinical outcomes, discharge planning, utilization management, denial management and/or case management. Must possess knowledge in continuum of care services and clinical pathways. Demonstrated leadership skills.

 

Licensure: Must be licensed as a Registered Nurse in the State of Virginia or Compact State.  

 

Other minimum qualifications: Demonstrated leadership and interpersonal skills. Excellent oral and written communication. Analytical skills necessary. Extensive knowledge of licensure, accreditation, ethical and legal guidelines for health care. Must possess computer skills and understanding of electronic medical records systems. Should have knowledge of insurance practices and ability to interpret benefit plans.  Knowledge of managed care strongly recommended.

 

Our Values

Below are our core values that we strive to embody and expect of all our team members:

CommUNITY:  Working in unison to serve our community, our Carilion family and our loved ones.

Courage:  Doing what’s right for our patients without question.

Commitment:  Unwavering in our quest for exceptional quality and service.

Compassion:  Putting heart into everything we do.

Curiosity:  Fostering creativity and innovation in our pursuit of excellence.

 

 

Requisition Number: 9361 
Employment Status: Full time 
Location: CRMH - Carilion Roanoke Memorial Hospital 
Shift: Day/Evening 
Shift Details: Full time hours with call required.
Recruiter: DANA E JOHNSON 
Recruiter Phone: 540-983-4006 
Recruiter Email: dejohnson@carilionclinic.org 

 

ABOUT CARILION:
As a not-for-profit organization, we pride ourselves on investing in our employees and the communities we serve. 
 

Our employees strive to provide quality care in serving over 1 million residents in Virginia while living and growing their careers in the country's most livable cities and towns. 
 

Headquartered in Roanoke, Va., Carilion Clinic is a robust system of small and large award-winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.
 

Equal Opportunity Employer
Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
 

Carilion Clinic is a drug-free workplace.

 

Posting Notes:


Nearest Major Market: Roanoke

Job Segment: Neurology, Manager, Medical, Orthopedic, Patient Care, Healthcare, Management

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