Minimum Qualifications
Education: Bachelors of Nursing (BSN) or Masters Social Work (MSW). Masters degree preferred
Licenses/Certifications:
Current and valid license to practice as a Registered Nurse in the state of Georgia or
Current and valid Georgia as a Master’s Social Worker (LMSW) required,
LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM) or
Fellowship of the American Academy of Case Management (FAACM) required .
Experience/ Knowledge/ Skills:
Minimum five (5) years’ experience in utilization management, case management, discharge planning or other cost/quality management program
Three (3) years of experience in hospital -based nursing or social work preferred
Knowledge of leading practice in clinical care and payor requirements
Self -motivated, proven communication skills, assertive
Background in business planning, and targeted outcomes
Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management
Working knowledge of the concepts associated with Performance Improvement
Demonstrated effective working relationship with physicians
Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes
Effective oral and written communication skills
Principal Accountabilities