Interim RN Director Case Management and Utilization Management

Baltimore, MD, United States

Details Department: Ascension Interim Leadership Travel Program

Schedule: Monday - Friday, 8am-5pm, on call as needed

Hospital: St. Agnes

Location: Baltimore, Maryland

This is an internal Interim contract for 3-6 months.

Benefits Paid time off (PTO)

Various health insurance options & wellness plans

Retirement benefits including employer match plans

Long-term & short-term disability

Employee assistance programs (EAP)

Parental leave & adoption assistance

Tuition reimbursement

Ways to give back to your community

*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: Travel, PRN, Short-Term Option, etc.). Actual compensation offer will vary based upon role, education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics.

Responsibilities Case Management:

Provides leadership to and actively participates with facility staff to identify, implement, or enhance CM programs consistent with Ascension and Market strategy

Identifies process improvement opportunities; develops, implements, monitors, and revises action plans

Actively seeks to identify and share best practices • Disseminates information accurately and timely with multiple audiences; leads regularly scheduled communication sessions with hospital CM Directors

Facilitates CM education within the Market; provides orientation and onboarding support to new hospital CM leaders

Identifies and proposes opportunities to improve current technology or identifies new technology to enhance performance and productivity

Escalates issues to Market leadership and Sr Dir of CM as appropriate • Performs other duties as assigned

Utilization Management:

Ensures integration of utilization management functions with network strategy and claims processing.

Oversees work with provider relations on resolving issues.

Manages activities related to staffing, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.

Develops systems and processes for prospective, concurrent and retrospective utilization review for all self-funded and fully insured clients to implement and manage comprehensive outpatient and inpatient utilization management programs.

Oversees implementation and maintenance of prior authorization codes for all clients.

Requirements Licensure / Certification / Registration:

BLS Provider obtained within 1 Month (30 days) of hire date or job transfer date required. American Heart Association or American Red Cross accepted.

Registered Nurse obtained prior to hire date or job transfer date required.

Education:

Bachelor's degree in nursing or diploma from an accredited school/college of nursing required. Master's degree or combination of Bachelor's degree and experience preferred.

Work Experience:

5 years of experience required.

10 years of experience preferred.

2 years of leadership or management experience required.

5 years of leadership or management experience preferred.

Additional Preferences Master's preferred.

Certified as ACM-RN or CCM preferred.

Why Join Our Team Ascension associates are key to our commitment of transforming healthcare and providing care to all, especially those most in need. Join us and help us drive impact through reimagining how we can deliver a people-centered healthcare experience and creating the solutions to do it. Explore career opportunities across our ministry locations and within our corporate headquarters.

Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.

Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.

Equal Employment Opportunity Employer Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.

For further information, view the  EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.

As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.

Pay Non-Discrimination Notice

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.

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