RN Clinical Resource Manager

Job Description

Networks Connect is seeking an experienced RN Clinical Resource Manager to lead a dynamic team for our client, a prominent health system in Washington, DC. This role involves supervising the daily operations of our care management team, including specialized care nurses, social workers, and community health programs. The Manager will also provide education on clinical care levels, financial issues, and lead initiatives to optimize performance outcomes.

Key Responsibilities

  • Leadership and Supervision: Oversee the daily work of the case management and community health teams. Lead hospital-wide initiatives to optimize care management and financial processes.
  • Education and Training: Provide education within inpatient settings and community health programs. Develop and lead educational programs for case management staff.
  • Data Analysis and Reporting: Analyze and report data related to case management, payer activities, and resource utilization. Present productivity and outcome data to improve departmental performance.
  • Operations Management: Supervise case managers, social workers, and community health coordinators. Manage staffing schedules, address issues with payers, and assist with high-risk cases.
  • Resource Management: Lead projects related to payer performance and manage human resources activities. Enhance staff performance and ensure compliance with billing and regulatory standards.
  • Performance Improvement: Track and improve clinical, operational, and financial data. Implement processes to reduce denials and optimize reimbursement.

Qualifications

  • Education: Master’s degree in Nursing (Required)

Experience

  • 7 years of clinical nursing experience. (Required)
  • 5 years of case management experience, including care coordination, discharge planning, and utilization review. (Required)
  • 3 years of supervisory experience. (Required)

Skills and Knowledge

  • Proficient in Microsoft Office (Word, PowerPoint, Excel, Access).
  • Excellent communication and presentation skills.
  • Experience with medical management criteria (MCG, InterQual) and Cerner systems.
  • Strong analytical skills for financial and productivity data.

Licenses and Certifications

  • Registered Nurse in the District of Columbia (Required)
  • Basic Life Support for Healthcare Provider (BLS) (Required)
  • Certified Case Manager (CCM) or Accredited Case Manager (ACM) (Preferred)

Organizational Values

  • Inclusiveness: Promote a culturally diverse and inclusive community.
  • Compassion: Treat everyone with empathy and compassion.
  • Adaptability: Continuously adapt to meet the changing needs of the community.
  • Independence: Support individuals in achieving increased independence.

Work Environment

Location: Washington, District of Columbia

Schedule: Full-time, 8:30 AM – 5:00 PM M-F

Join our clients team to make a significant impact on the lives patients with special health care needs. Apply now to be a part of our mission-driven organization dedicated to providing high-quality, community-based care.

Earnings

$120,000 - $140,000 salary

Location - In Office

  • Washington D.C.

Job Type

Full-time

Category

Revenue Cycle

Apply Now
CLOSE X
Click or drag files to this area to upload. You can upload up to 2 files.
.doc, .docx, .rtf, .txt, .pdf