AVP Case Management
Company: OU Medicine
Location: Oklahoma City
Posted on: March 18, 2023
Job Description:
The Assistant Vice President of Case Management (AVPCM) provides
leadership and direct oversight for Case Management and Social
Services to include: Utilization Management, Discharge Planning,
Precertification & Denials Management, Retrospective Medicaid,
Medical Necessity Denials and Care Transitions for OU Health (OUH).
The AVPCM sets the overall direction for assigned areas and
implements policies, processes and procedures throughout the
organization; provides direct supervision to Directors of Case
Management and all associated personnel and is responsible for the
program development, Utilization Review, Discharge Planning,
Documentation Assurance and Perspective Payment System management
activities throughout OUH.Responsibilities listed in this section
are core to the position. Inability to perform these
responsibilities with or without an accommodation may result in
disqualification from the position. -
- Directs and supervises case management, social services, and
revenue integrity team members.
- Promotes quality, cost effective care through management of
access-to-care in the Emergency Department, progression of care,
barriers to delivery of care, and transition to lower level of care
or discharge back to the community.
- Utilizes extensive and creative planning and resource
identification to enhance discharge planning for patients with
limited financial and supportive resources.
- Directs the implementation of utilization management and
regulatory compliance.
- Promotes evidence based care through physician
partnership.
- Advocates for patient/family to meet their social and emotional
needs as they impinge on their medical condition, treatment,
recovery, and safe transition from one care environment to another.
-
- Provides crucial services to children who are suspected victims
of child abuse through the Child Protection Team.
- Provides consultative leadership, educational development, and
support to OUH facilities regarding resources, regulatory
compliance, and financial concerns.
- Assumes overall responsibility for Case Management.
- Demonstrates quality and financial outcomes for the
department.General Responsibilities:
- Performs other duties as assignedMinimum
Qualifications:Education: Master's Degree in Nursing OR Social
WorkExperience: Ten years of nursing experience including eight
years of Case Management or similar experience; Five years of
progressive management experience to include at least one year with
frequent involvement with senior management, physicians and outside
patient care providers; Experience with insurance precertification,
utilization management and DRG management;
License(s)/Certification(s)/Registration(s) Required: Current RN
License issued by the Oklahoma State Board of Nursing, or a current
multistate compact RN License (eNLC). Certification in Case
Management (ACM, CCM, HCQM, CMAC) preferred.Knowledge, Skills and
Abilities:Excellent customer service, collaborative interpersonal
and communication skills, with the ability to obtain and foster
positive relationships within OU Health; Working knowledge of
statistics and performance improvement tools and techniques;
Excellent management, communication, problem solving,
decision-making and critical thinking skills; Proficient with the
use of Microsoft Office and applicable Case Management Information
Systems (CMIS); Excellent organizational and interpersonal skills
including the ability to manage multiple projects and work
collaboratively with OUH leaders and team members; Knowledge of the
principles and practices of social and psychological casework. Must
be knowledgeable about resources available in the community for use
by patients, families and the health care team that would
facilitate in the recovery of the patient. Requires knowledge of
third party payer issues concerning reimbursement and regulatory
perimeters. -Current OU Health Employees - Please click HERE to
login. OU Health is an equal opportunity employer. We offer a
comprehensive benefits package, including PTO, 401(k), medical and
dental plans, and many more. We know that a total benefits and
compensation package, designed to meet your specific needs both
inside and outside of the work environment, create peace of mind
for you and your family. About Us OU Health is the state's only
comprehensive academic health system of hospitals, clinics and
centers of excellence. With 11,000 employees and more than 1,300
physicians and advanced practice providers, OU Health is home to
Oklahoma's largest doctor network with a complete range of
specialty care. OU Health serves Oklahoma and the region with the
state's only freestanding children's hospital, the only National
Cancer Institute-Designated OU Health Stephenson Cancer Center,
Oklahoma's flagship hospital, which serves as the state's only
Level 1 trauma center and Edmond Medical Center in the heart of the
Edmond Community. Becker's Hospital Review named University of
Oklahoma Medical Center one of the 100 Great Hospitals in America
for 2020. OU Health's oncology program at OU Health Stephenson
Cancer Center was named Oklahoma's top facility for cancer care by
U.S. News & World Report in its 2020-21 rankings. OU Health also
was ranked by U.S. News & World Report as high performing in these
specialties: Colon Surgery, COPD and Congestive Heart Failure. OU
Health's mission is to lead healthcare in patient care, education
and research. Experts in prevention, treatment and cures, our team
works to improve lives through innovation in medical care,
education and research, while investing in the people, technologies
and facilities that will enable us to achieve our goals. We are
seeking individuals who have a passion and talent for caring for
others. By joining our team, you will provide quality health care
to our community through the work you do every day. We provide
clinical and non-clinical opportunities to further your career and
we invite you to explore our available positions.Equal employment
opportunities are provided to all employees and applicants for
employment without regard to race, color, religion, gender,
national origin, age, disability, sexual orientation, gender
identity, genetic information or protected veteran status in
accordance with applicable federal laws. This policy applies to all
terms and conditions of employment, including, but not limited to,
hiring, placement, promotion, termination, layoff, transfer, leaves
of absence, compensation, and training. Reasonable accommodations
are made to the known physical and mental limitations of qualified
individuals with disabilities.
Keywords: OU Medicine, Oklahoma City , AVP Case Management, Executive , Oklahoma City, Oklahoma
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