Skip Navigation

Search Jobs

Search Jobs

QA / UR / Case Management Jobs

Director, Inpatient Continuing Care - Rockville, MD

Location: Rockville, Maryland;

Job ID : 547200


The Director of Inpatient Continuing Care provides leadership, direction and oversight of all inpatient continuing care activities. This position is responsible for establishing efficient and organized processes to support excellent quality and service. The Director of Inpatient Continuing Care partners with other leaders from the Health Plan and MAPMG to ensure execution of program goals.

Essential Functions:
  • Develops and implements all components of the Hospital Utilization Management program and ensures compliance with NCQA, state, federal and other regulatory accreditation standards.
  • Provides leadership and direction in the design and implementation of workflows and processes to promote timely and smooth transitions of care from the inpatient setting.
  • Partners with health plan and MAPMG staff to develop strategic plans, providing quality and cost effective care in the inpatient setting.
  • Develops, maintains and manages relationships with hospital partners, providers and other external vendors.
  • Develops and implements processes to support efficient management of inpatient continuing care teams.
  • Participates in developing UM work plan and ensures adherence to all quality and operational initiatives and goals.
  • Manages budget performance and executes appropriate strategies to manage cost and improve quality of care and services.
  • Partners with other members of the Continuing Care team to develop and implement collaborative processes and outcomes.
  • Supports professional growth by providing education, training and appropriate resources. Conducts performance evaluations, provides coaching and acts as a mentor to direct reports.
  • Performs other related duties as assigned.
    Qualifications: Basic Qualifications:
  • Ten (10) years of experience in a clinical setting.
  • Five (5) years of experience in Utilization Management or Case Management.
  • Five (5) years of experience in a management or leadership position.
  • Bachelor's degree in nursing, health care administration or other health related field.
    License, Certification, Registration
  • Valid RN license in DC, MD or VA.
  • May be required to obtain additional state licenses as appropriate.

    Additional Requirements:
  • Proven track record of developing and implementing major projects on time and within budget required.
  • Proficient in computer applications including Microsoft Word, PowerPoint and Excel required.
  • Strong interpersonal skills, with good verbal and written communication skills required.
  • Skills in problem-solving and collaboration with other professions/ disciplines required.
  • Demonstrated experience in complex strategy formulation and implementation required.
  • Ability to work comfortably and effectively with senior management&physicians required.

    Preferred Qualifications:
  • Understanding of or experience working with state Medicare/Medicaid plans.
  • Understanding of or experience with NCQA or other accreditation guidelines.
  • Master's degree in nursing, health care administration or other health related field.
  • Certification in Case Management from Commission for Case Manager Certification or Nursing Case Manager Certification from American Nurses Credentialing Center.

    Primary Location:Maryland,Rockville,Rockville Regional Offices 2101 E. Jefferson St.

    Scheduled Hours (1-40):40


    Working Days:Mon - Fri


    Job Type:Standard

    Employee Status:Regular

    Employee Group:Salaried, Non-Union, Exempt

    Job Level:Director/Senior Director

    Job:QA / UR / Case Management

    Public Department Name:Continuing Care / UM

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
  • Click here for additional requirements

    Recent kaiser permanente jobs