POSITION SUMMARY

The Director of Care Management and Social Work oversees the care coordination of the Care Management and Social Work programs at the hospital, which provides a comprehensive array of patient assessment, care coordination and education. In this role you will serve as an advocate for patients and families and as a resource and educator for hospital personnel and medical staff. You will use your leadership skills to oversee hospital Care Managers and Social Workers as well as the Utilization Management program.

BENEFITS

• Competitive salary 
• Annual retirement contribution of 6% of salary plus a 1% match.
• Generous Earn time off benefit. 
• Health, dental, and vision insurance covered 80% by the organization. 

QUALIFICATIONS

• EDUCATION:
  • Graduate of NLN accredited school of nursing BSN Preferred, and MS would be desirable; or Graduate degree in Social Work, Mental Health Counseling, or other related field.
  • Bachelor’s degree and relevant experience may substitute for graduate education.
• EXPERIENCE/SKILL SETS:
  • 5-7 years progressive experience in Med-Surg nursing, social work, public health nursing, utilization review or discharge planning experience required. 
  • Previous experience in a management/leadership role.
  • Psychiatric nursing is of additional value.
  • An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.
  • Excellent verbal, written and presentation communication skills; highly developed organizational, interpersonal, and management skills.
• LICENSURE/CERTIFICATION(S):
  • Vermont state RN license or Vermont State Clinical Social Worker license required. Remains current with continuing education/CEU requirements.
• RESPONSIBILITIES
  • Oversees the organization's utilization management program.
  • Responsible for assisting CMs in performing admission and concurrent review.
  • Coordinates issuance of non-coverage letters by CMs at the time of discharge when applicable.
  • Responsible for assisting CMs in coordinating patient discharge plans with physician insurance carriers, social work services, patient and family.
  • Communicates with insurance carriers as necessary to ensure appropriate authorization of services.
  • Maintains compliance with state and federal guidelines as well as CMS CoP standards.
  • Facilitates the provision of information by CMs in response to concurrent payer queries.
  • Utilizes criteria and standards for concurrent review requirements in supervising CMs.
  • Prepares and distributes LOS reports weekly to Senior Leadership Team.