Job Description

Location: Carney Hospital
Posted Date: 3/14/2023

About Steward Health Care
Nearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country’s largest physician-led, tax paying, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
Based in Dallas, Steward currently operates 39 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah.
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At Steward Health Care System, we are committed to improving the health of our communities by delivering exceptional, personalized health care with dignity, compassion and respect. Our continued focus on the patient experience informs our caregivers in how to provide care that is respectful of and responsive to individual patient and family preferences, needs and values.

We dedicate ourselves in the communities we serve to delivering affordable health care to all and being responsible partners. No matter what your role, as a member of the Steward family, you are a specialist in the making every patient and family feel right at home, every co-worker a key to our success, and every referring practice, a team of prized colleagues.

In support of this, we commit ourselves to the following values:






If you are seeking a fast-paced, challenging position in an organization committed to achieving and maintaining a standard of excellence in all we do, our organization may be a good fit for you.


  • Evaluates, develops, implements and monitors utilization and case management and activities to promote quality and cost effective results.
  • Collaborates with Social Work, Q.I. Nursing, Fiscal, Managed Care and other clinical departments as well as physicians, hospital administration, community agencies, and third party payers with an emphasis toward providing excellent patient care across the care continuum within a fiscally responsible framework.

Fiscal Responsibilities – reporting to Chief Financial Officer

  • Directs member’s need for case management services, including verifying eligibility, benefit and insurance limitations, medical necessity and appropriateness of referral
  • Reviews case management referrals by communication directly with physicians, HMO’s Medical Director, hospital staff and other appropriate ancillary providers on a regular basis
  • Assesses quality of contracted vendors including quality outcomes, patient and physician satisfaction, cost and service levels
  • Supervises the tracking of all referral and DME services
  • Attends leadership meetings, participates in committees, identified and manages department priorities, plans budget and reviews staff

Clinical Responsibilities – reporting to Chief Medical Officer

  • Responsible for supervising and/or performing case management, utilization review, quality assurance, and discharge planning
  • Responsible for assisting CM’s in the assessment, identification, and awareness of services available to patients and families at the time of discharge
  • Responsible for assisting CM’s in performing admission and concurrent review, and retro-review of all inpatients conforming to CMS requirements
  • Coordinates Issuance of non coverage letters by CM’s at time of discharge when applicable
  • Performing surveillance and data collection as directed for trend recognition and development of effective action plans
  • Maintains compliance with state and federal guidelines as well as Joint Commission and CMS CoP standards
  • Facilitates the Provision of information by CM’s in response to payer queries
  • Participates in Continuing Education and other appropriate learning to maintain professional growth
  • Utilizes Interqual criteria and standards for concurrent review requirements in supervising CM’s
  • Prepares and distributes 3 day LOS reports daily to SLT
  • Daily participation in morning rounds with house staff, CM’s and hospitalists in conjunction with the CMO
  • Analyzes and presents clinical and utilization data to physician groups
  • Educates clinical staff on alternative to acute care including new technology/alternatives for high tech home health, extended care and disease management initiatives.
  • Supervises staff and provide direct services to inpatient units
  • Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.

1. Commits to recognize and respect cultural diversity for all customers (internal and external).

2. Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs and ages, utilizing interpreters when needed.

  • Performs other duties as assigned


  • Previous supervisory experience required
  • Good finance/budgeting skills
  • Ability to work independently and take initiative
  • Good judgment and problem solving skills
  • Strong communication, interpersonal and organizational skills
  • High level of confidentiality


  1. Education: Graduate of an NLN accredited school of nursing; Bachelor’s degree in nursing required and MS would be desirable
  2. Experience: 3 to 5 years inpatient care management experience in an acute care setting, could be rehab or chronic care hospitals; experience with Medicare regulations; experience with patient advocacy and quality improvement programs is preferred; union environment experience would be a plus.
  3. Certification/Licensure: RN licensure in MA
  4. Software/Hardware:
  5. Other:

Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

Additional Information

Important COVID message

Please note, our Carney Hospital is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment - with confidence and without fear. Our Safe and Ready program consists of a rigorous [five-point] standard ensuring patient safety, confidence and convenience: Expanded hours will allow previously canceled procedures to be scheduled as quickly as possible. Any COVID-19 related care takes place in designated areas away from other patients and their families. Emergency Departments are reorganized to be a safe place to treat all emergency patients. A stringent cleaning policy has been implemented throughout the hospital. A strictly controlled visitor and masking policy is required for patient safety. You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.

Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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