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Case Management Society of America - Middle Tennessee Chapter

Posting of Employment Opportunities on the Middle Tennessee Chapter of CMSA Website Policy

The Middle Tennessee Chapter of CMSA provides written guidelines pursuant to the use of the website for the purpose of posting available jobs. All parties requesting a job posting on the Middle Tennessee Chapter's website are subject to these terms:

CMSA members and corporate sponsors are permitted to post job openings for a fee of $65. Per initial 30-day posting, with one additional consecutive thirty-day posting for a fee of $25. All fees are payable in advance by check.

All other requests are posted for a fee of $100 per initial 30-day posting, with an additional consecutive thirty day posting for a fee of $65. All fees are payable in advance by check. Ads will automatically be included in the newsletter.

If you prefer to advertise in the newsletter only, sponsors are still free. Non-sponsors will be charged $25 per ad.

Purpose
The purpose of this policy is to provide a value-add for Middle Tennessee Chapter members and corporate sponsors, offset website expenses, as well as to enhance membership and corporate sponsor benefits.

Posting Time Limit:
Job postings are maintained on the Middle Tennessee Chapter website for a period of 30 calendar days, after which they will be removed. Requests for an extension of the original posting period are payable in advance by check. Checks for extension of the original posting must be received by the third week of the month. It is the responsibility of the posting organization to request the extension within the time frame.

Submission and Review Process
Job posting should be submitted for review to the infoCMSA@cmsa-TN.org . Text and format will be edited to ensure conformity to Middle Tennessee Chapter's website standards and space restrictions. Website job postings can be submitted at any time for posting on website on the first day of the next month.

Content 
Job postings should be limited to 200 words or less in length and be descriptive of a specific position, its responsibilities and required qualifications. Contact information for interested candidates should be clearly noted at the end of the posting. Advertisements are subject to editing to conform to guidelines and space limitations.

Sample Posting
Clearly note the job title, hours and location in the title line. This is followed by a brief synopsis of the position responsibilities and required education, certification and/or skills.

Care Coordinator-40 hours/wk-Boston, MA
Responsibilities: Discharge planning, utilization review, and quality screening for patients in the acute care setting of an acute care facility. Solid problem solving skills and demonstrated ability to work with patients, families, and physicians required. Must be able to work collaboratively with other healthcare professionals. Qualifications: RN with current state license, five to seven years of medical-surgical experience, including at least one year of discharge planning or home care. Case management certification preferred. Previous use of UM criteria set(s) preferred. Demonstrated communication skills, strong work ethic and ability to work well in a team environment are required. Please contact Rhonda Recruiter at xxx-xxx-xxxx, or by email at www.xxx.com , for additional information.

Approved:__________________________________ Date:_____________

LIST OF JOB OPENINGS


Case Management Leadership Role!

The Organization: Baptist Memorial Health Care System
Regarded as one of the premier health care systems in the nation, Baptist Memorial Health Care is an award-winning network dedicated to providing compassionate, high-quality care for patients. With 15 affiliate hospitals throughout the Mid-South, Baptist combines convenience with excellence of care.
With the intention of caring for people close to their homes, the Baptist system also offers more than 3,100 affiliated physicians; home, hospice and psychiatric care; minor medical clinics; a network of surgery, rehabilitation and other outpatient centers; Baptist Medical Group, the Memphis area’s largest multispecialty physician group; and an education system highlighted by the Baptist College of Health Sciences.
 
Baptist Memorial Hospital-Memphis
The Baptist Memorial Hospital-Memphis campus includes the flagship hospital of the Baptist Memorial Health Care system. Opened in 1979, the hospital is located adjacent to the I-240 loop. Also located on the Baptist Memphis campus is the 30-bed Restorative Care Hospital. With almost 27,000 discharges, 55,000 emergency department visits and 14,000 surgeries in 2010, Baptist Memphis is one of Tennessee's highest volume hospitals.
 
Key Responsibilities
Provides leadership for the Case Management Department including department and program planning, development, staffing, budget, analysis, tracking, and reporting of associated clinical and utilization management related programs to support clinical integration, value based purchasing, transition (discharge) planning, and other health care reform related changes and initiatives.  Maintains continued focus on regulatory compliance, revenue cycle and cost reductions, including LOS, unreimbursed care, and the implementation of guidelines and protocols that improve clinical quality and process.
 
Requirements
Reporting to the Chief Medical Officer, the candidate must be a Registered Nurse with knowledge of case management/utilization management and insurance process. Must have at least 5 years of clinical experience, 1 year management in healthcare setting, at least 2  year’s experience in case management.
Prefer certification-Certified Case Manager or Accredited Case Manager.

Internal Audit - Opening
​Clinical Compliance

Clinical Compliance Audit Manager/Senior Manager (Internal Audit)
United States-Tennessee-Nashville-Corporate Main Campus

The Internal Audit Department provides an independent appraisal function to validate management control systems, assess risk, and support corporate management in the effective discharge of their responsibilities and efforts to achieve the Company's overall mission.  The Clinical Compliance Team work includes a variety of audits which test the medical records and corresponding bills, and processes/systems to ensure compliance with company policies and government regulations.  The purpose of the audits is to assist facility management in determining compliance with company-defined processes and federal regulatory requirements. The team works closely with facility, division, and group management personnel as well as corporate executives.  Position reports to the Director of Clinical Compliance, Internal Audit.
 
RESPONSIBILITIES 
  • Conducts reviews of hospital/center systems to ensure compliance with applicable legal regulatory requirements as defined by federal and state regulations and company policy.
  • Develops detailed reports specifying compliance issues identified during the audit. 
  • Assists the facility with action plan development and follow-up questions as necessary.
  • Demonstrates a thorough understanding of federal and state regulations and Joint Commission standards regarding review areas.
  • Discusses complex auditing issues with engagement team and client management.
  • Participates in the audit quality assurance program.
  • Communicates (clearly) the objectives of each review and planned other services to the client engagement team and establishes/communicates team members’ roles in the process.
  • Understands HCA’s business and the healthcare industry from a global perspective by recognizing business trends and emerging technical and industry developments of relevance and communicates these to the client engagement team and applicable management personnel.
  • Provides input in the review of the detailed audit/review programs, processes, controls, and transactions.
  • Executes audit procedures, analyzes evidence, reaches conclusions, identifies issues, develops strategies, and makes decisions for complex, judgmental issues in conjunction with the director, related to the review procedures executed.  Consults with others in the Company, in conjunction with the director, as necessary, on complex issues.
  • Enters/reviews working papers and memoranda into Teammate per requirements of the department.
  • Assists with educational and administrative matters (e.g. professional development programs, process improvement team initiatives, recruiting efforts, and special projects as requested by the Director).
 
SPECIFIC AREAS REVIEWED
  • National Coverage Determination, (Carotid Stents, Implantable Cardiac Defibrillators, Pacemakers, others).
  • Medicare Admission status, “Pay for Performance” measures including Core Measures, and National Healthcare Safety Network, others.
  • Privileged and Non-Privileged Licensure/Certification, and Telehealth.
  • Pharmacy Compounding, Controlled Substances, High Alert Medications, others.
  • Post-Acute Services: Inpatient/Outpatient Rehabilitation, Inpatient/Outpatient Psychiatric Services, Clinical Research, others
 
QUALIFICATIONS
  • College Graduate (from accredited School of Nursing)
  • Active RN Licensure with at least 5 years’ experience
  • Nursing management/supervisory experience
  • Case Management, Utilization Management, Quality, hospital, rehab, skilled, consulting experience is preferred
  • Proficient with Excel spreadsheet and Word processing software
  • Strong communication skills (oral and written)
  • Superior client service and business development skills, dedication to teamwork
  • Ability to work well with deadlines and related time pressure
  • Ability to lift up to 25 pounds
  • Ability to travel  25 – 30%   
Program Consultant 
State of Tennessee 252 reviews - Nashville, TN

The Aging Program Consultant position serves as the State Public Guardian and is responsible for all aspects of the Public Guardianship for the Elderly program contained in TCA Title 34-7-102. This statute establishes the program and gives responsibility to the TN Commission on Aging and Disability. The program adheres to all state statutes regarding conservatorship. The position is responsible for quality assurance and monitoring the nine District Public Guardianship for the Elderly programs across the state. These district programs are responsible for carrying out the court orders that appoint them as conservators over healthcare decisions and property of wards who have no other person or entity to care for them. The position must provide training for the District Public Guardians, their attorneys, their accounting staff, and volunteers. The position monitors each program to determine compliance with court orders and the submission of property inventory, property management plans, annual accounting and final accountings by the dates specified by the court order. The position is responsible for monitoring the District Public Guardians responsible for paying nursing home bills, taxes, disposing of property, etc. The Tennessee Commission on Aging and Disability seeks a person to fill this position experienced and knowledgeable in working with the courts; developing care plans; managing property; overseeing accounts; and developing training for attorneys and volunteers. We are seeking a candidate with a management degree or legal or paralegal experience.
Job Type: Full-time
Required education:
  • Master's
Required experience:
  • Paralegal: 3 years
  • Program Management: 3 years
  • Management: 3 years​

Director of Care Management to Join Texas Children's Health Plan

Texas Children’s Health Plan has engaged Cejka Executive Search to lead a national search for a Director of Care Management. The Director will oversee Case Management, Utilization Management, and Disease Management for the 400,000 STAR and CHIP members.  S/he will report directly to the CMO while leading the development, direction, execution  and evaluation of effective care enhancement programs the support the delivery of the highest quality care.  The Director will devlop and oversee systems and dashboards to ensure effective coordination between care management, quality , claims, customer service, provider relations and network contracting.  The person will be the subject matter expert in care management for external relationships and consultantions.
 
The successful candidate will demonstrate a history of success as a nurse executive in a managed care environment, with particular expertise in the development and oversight of integrated care management models for high acuity and pediatric patient populations. Exceptional communication and leadership skills are essential.
 
Recommendations of qualified candidates are welcome. For more information please contact and/or forward your CV to my attention.
 
Todd Wozniak, CIR CRA
Senior Associate Consultant
 
Cejka Executive Search℠
4 CityPlace Drive, Suite 300
St. Louis, MO 63141
314.236.4493 Office
twozniak@cejkasearch.com
cejkaexecutivesearch.com
linkedin.com/in/twozniakcejka

BrickStreet Insurance
Sr. Nurse Case Manager posting

Would you like to apply your nursing skills to a professional business setting?  Would you like to work in a dynamic, diverse work environment that encourages autonomy, creativity, flexibility and a consistent work schedule?
 
If yes, BrickStreet Mutual Insurance provides a unique career opportunity for our nurses. 

The Senior Nurse Case Manager serves as a skilled nurse case management resource to advise the business teams in the resolution of complex medical issues.  This position facilitates timely, comprehensive interventions and achievement of effective, cost-efficient outcomes in the disability and claims management processes. 

To view our posting&/or apply, please visit www.brickstreet.com or follow the link below. 

https://brickstreet.silkroad.com/epostings/index.cfm?fuseaction=app.jobinfo&id=23&jobid=290776&company_id=15702&version=1&source=ONLINE&JobOwner=1006767&level=levelid1&levelid1=102613&parent=Nurse%20Case%20Management&startflag=2

Shelby L. Paxton
Human Resources Associate
BrickStreet Insurance
Phone: 304-941-1000 ext. 5640
Fax: 304-941-1198
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