AVP - Case Management
Company: Ochsner Clinic Foundation
Location: New Orleans
Posted on: May 2, 2024
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Job Description:
We've made a lot of progress since opening the doors in 1942,
but one thing has never changed - our commitment to serve, heal,
lead, educate, andinnovate.Webelieve that every award earned, every
record broken and every patient helped is because of the dedicated
employees who fill our hallways. At Ochsner, whether you work with
patients every day or support those who do, you are making a
difference and that matters. Come make a difference at Ochsner
Health and discover your future today! This job provides leadership
and direct oversight for case management and social services
including utilization management, discharge planning,
precertification and denials management, retrospective Medicaid,
medical necessity denials and care transitions for the
organization. Ensures quality of care and patient satisfaction
through oversight of policies, procedures, and improvements. To
perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill, and/or ability
required. Reasonable accommodations may be made to enable qualified
individuals with disabilities to perform the essential duties. This
job description is a summary of the primary duties and
responsibilities of the job and position. It is not intended to be
a comprehensive or all-inclusive listing of duties and
responsibilities. Contents are subject to change at the company's
discretion.
Education Required -Bachelor's degree in business, nursing,
education or related healthcare field. Preferred - Master's degree
in business, nursing, education or related healthcare field. Work
Experience
Required -10 years of experience in case management or related
field.
Progressive management experience to include frequent involvement
with senior management, physicians and outside patient care
providers.
Experience with insurance precertification, utilization management
and diagnosis-related group (DRG) management. Certifications
Required -None. Preferred - Current registered nurse (RN) license
in state of practice. Certification in case management (ACM, CCM,
HCQM, CMAC). Knowledge Skills and Abilities (KSAs)
The physical demands described here are representative of those
that must be met by an employee to successfully perform the
essential functions of this job. Reasonable accommodations may be
made to enable individuals with disabilities to perform the
essential functions. Light Work - Exerting up to 20 pounds of force
occasionally, and/or up to 10 pounds of force frequently, and/or a
negligible amount of force constantly (Constantly: activity or
condition exists 2/3 or more of the time) to move objects. Physical
demand requirements are in excess of those for Sedentary Work. Even
though the weight lifted may be only a negligible amount, a job
should be rated Light Work: (1) when it requires walking or
standing to a significant degree; or (2) when it requires sitting
most of the time but entails pushing and/or pulling of arm or leg
controls; and/or (3) when the job requires working at a production
rate pace entailing the constant pushing and/or pulling of
materials even though the weight of those materials is negligible.
NOTE: The constant stress and strain of maintaining a production
rate pace, especially in an industrial setting, can be and is
physically demanding of a worker even though the amount of force
exerted is negligible. Because the incumbent works within a
healthcare setting, there may be occupational risk for exposure to
hazardous medications or hazardous waste within the environment
through receipt, transport, storage, preparation, dispensing,
administration, cleaning and/or disposal of contaminated waste. The
risk level of exposure may increase depending on the essential job
duties of the role. #LI-SF1 Are you ready to make a difference?
Apply Today! Ochsner Health does not consider an individual an
applicant until they have formally applied to the open position on
this careers website. Individuals who reside in and will work from
the following areas are not eligible for remote work position:
Colorado, California, Washington, New York, and Washington D.C.
Ochsner Health endeavors to make our site accessible to all users.
If you would like to contact us regarding the accessibility of our
website, or if you need an accommodation to complete the
application process, please contact our HR Employee Solution Center
at 504-842-4748 (select option 1) or. This contact information is
for accommodation requests only and cannot be used to inquire about
the status of applications. We are proud to be an Equal Employment
Opportunity and Affirmative Action employer. We are committed to
the principles of equal employment opportunity and providing a
workplace that is free from discrimination based on race, color,
creed, religion, pregnancy status, pregnancy-related conditions,
national origin, ancestry, mental or physical disability, medical
condition, age, veteran status, military status, citizenship
status, marital status, familial status, sexual orientation,
gender, gender identity or expression, genetic information,
political affiliation, unemployment status, or any other
characteristic protected under applicable federal, state or local
law. These protections extend to applicants and all employment
related decisions. View theand its, as well as thefor more
information. We've made a lot of progress since opening the doors
in 1942, but one thing has never changed - our commitment to serve,
heal, lead, educate, andinnovate.Webelieve that every award earned,
every record broken and every patient helped is because of the
dedicated employees who fill our hallways. At Ochsner, whether you
work with patients every day or support those who do, you are
making a difference and that matters. Come make a difference at
Ochsner Health and discover your future today! This job provides
leadership and direct oversight for case management and social
services including utilization management, discharge planning,
precertification and denials management, retrospective Medicaid,
medical necessity denials and care transitions for the
organization. Ensures quality of care and patient satisfaction
through oversight of policies, procedures, and improvements. To
perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed
below are representative of the knowledge, skill, and/or ability
required. Reasonable accommodations may be made to enable qualified
individuals with disabilities to perform the essential duties. This
job description is a summary of the primary duties and
responsibilities of the job and position. It is not intended to be
a comprehensive or all-inclusive listing of duties and
responsibilities. Contents are subject to change at the company's
discretion.
Education Required -Bachelor's degree in business, nursing,
education or related healthcare field. Preferred - Master's degree
in business, nursing, education or related healthcare field. Work
Experience
Required -10 years of experience in case management or related
field.
Progressive management experience to include frequent involvement
with senior management, physicians and outside patient care
providers.
Experience with insurance precertification, utilization management
and diagnosis-related group (DRG) management. Certifications
Required -None. Preferred - Current registered nurse (RN) license
in state of practice. Certification in case management (ACM, CCM,
HCQM, CMAC). Knowledge Skills and Abilities (KSAs)
The physical demands described here are representative of those
that must be met by an employee to successfully perform the
essential functions of this job. Reasonable accommodations may be
made to enable individuals with disabilities to perform the
essential functions. Light Work - Exerting up to 20 pounds of force
occasionally, and/or up to 10 pounds of force frequently, and/or a
negligible amount of force constantly (Constantly: activity or
condition exists 2/3 or more of the time) to move objects. Physical
demand requirements are in excess of those for Sedentary Work. Even
though the weight lifted may be only a negligible amount, a job
should be rated Light Work: (1) when it requires walking or
standing to a significant degree; or (2) when it requires sitting
most of the time but entails pushing and/or pulling of arm or leg
controls; and/or (3) when the job requires working at a production
rate pace entailing the constant pushing and/or pulling of
materials even though the weight of those materials is negligible.
NOTE: The constant stress and strain of maintaining a production
rate pace, especially in an industrial setting, can be and is
physically demanding of a worker even though the amount of force
exerted is negligible. Because the incumbent works within a
healthcare setting, there may be occupational risk for exposure to
hazardous medications or hazardous waste within the environment
through receipt, transport, storage, preparation, dispensing,
administration, cleaning and/or disposal of contaminated waste. The
risk level of exposure may increase depending on the essential job
duties of the role. #LI-SF1 Are you ready to make a difference?
Apply Today! Ochsner Health does not consider an individual an
applicant until they have formally applied to the open position on
this careers website. Individuals who reside in and will work from
the following areas are not eligible for remote work position:
Colorado, California, Washington, New York, and Washington D.C.
Ochsner Health endeavors to make our site accessible to all users.
If you would like to contact us regarding the accessibility of our
website, or if you need an accommodation to complete the
application process, please contact our HR Employee Solution Center
at 504-842-4748 (select option 1) or. This contact information is
for accommodation requests only and cannot be used to inquire about
the status of applications. We are proud to be an Equal Employment
Opportunity and Affirmative Action employer. We are committed to
the principles of equal employment opportunity and providing a
workplace that is free from discrimination based on race, color,
creed, religion, pregnancy status, pregnancy-related conditions,
national origin, ancestry, mental or physical disability, medical
condition, age, veteran status, military status, citizenship
status, marital status, familial status, sexual orientation,
gender, gender identity or expression, genetic information,
political affiliation, unemployment status, or any other
characteristic protected under applicable federal, state or local
law. These protections extend to applicants and all employment
related decisions. View theand its, as well as thefor more
information.
Keywords: Ochsner Clinic Foundation, Metairie , AVP - Case Management, Executive , New Orleans, Louisiana
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