Insurance and Risk Management Director directs the development and optimization of an organization's overall insurance program to manage and minimize risk and costs. Defines strategic objectives and policies to ensure effective insurance coverage for the organization and to develop risk financing budgeting. Being an Insurance and Risk Management Director implements processes that identify risk exposure and classify, measure, and manage insurable risks. Develops the appropriate mix of insurance coverage for the organization and negotiate policy pricing and terms with vendors. Additionally, Insurance and Risk Management Director requires a bachelor's degree. Typically reports to senior management. The Insurance and Risk Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be an Insurance and Risk Management Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)
ScionHealth is committed to a culture of service excellence as demonstrated by our employees’ adherence to the service excellence principles of Pride, Teamwork, Compassion, Integrity, Respect, Fun, Professionalism, and Responsibility.
As our most acute level of care, our specialty hospitals offer the same critical care patients receive in a traditional hospital or intensive care unit, but for an extended recovery period. Our clinicians play a vital role in the recovery process for chronic, critically ill and medically complex patients.
Job Summary: The Director of Case Management directs the Case Management and Utilization Management activities in a Kindred hospital. Oversees the facilitation of care coordination of the patient and family through the management of quality clinical service delivery. Partners with external customers, referral sources and payors to ensure the facilitation and coordination of the discharge planning process and serve as the patient and family advocate. Accountable for the facility’s denial management program. Ensures that case management services comply with the Conditions of Participation. Collaborates closely with the hospital CEO/Administrator, COO, CFO, CCO and District Office.
Essential Functions:
Education:
Graduate of an accredited program required:
RN or BSN preferred; or Masters of Social Work with licensure as required by state regulations; or Master’s degree in healthcare administration, business administration, or clinical specialty
Licenses/Certification:
Healthcare professional licensure required as Registered Nurse, Licensed Clinical Social Worker (LCSW),or Licensed Social Worker (LSW), as required by state.
Certification in Case Management preferred.
Experience:
Minimum three years’ experience in Hospital Case Management.
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0 Insurance and Risk Management Director jobs found in Janesville, WI area