Director of Case Management

POSITION SUMMARY

Responsible for monitoring quality patient standards, patient and payor satisfaction levels, and for ensuring that patients are receiving prioritized, cost-appropriate and quality services. Will assess, organize, develop, implement and evaluate the case management program and activities in accordance with current federal, state and local standards, guidelines and regulations and the Joint Commission standards. Demonstrates knowledge and skills necessary to provide case management services to the patient population experiencing medically complex conditions, general medical-surgical conditions with rehabilitation and wound care needs.

POSITION SUPERVISORY RESPONSIBILITIES

Supervises the following positions: Case management staff and other departmental staff as applicable.

POSITION QUALIFICATIONS

MINIMUM QUALIFICATIONS:

Current, valid, and active license to practice as a Registered Nurse in the state of employment or Master’s Degree of Social Work (MSW) required.

Minimum three (3) years of hospital case management experience required.

Current BLS certification.

ADDITIONAL QUALIFICATIONS/SKILLS:

Registered Nurse preferred.

Previous LTAC experience preferred.

ACM or CCM and CCDS certification preferred.

Previous management experience preferred.

Strong leader and manager, able to motivate staff to deliver high quality, results-oriented case management services.

Strong written and oral communication skills.

Assertive and personable with the ability to balance the complex challenge of delivering quality, cost-appropriate, and service-oriented outcomes.

Demonstrates comprehensive knowledge of the principles and concepts of case management and applicable standards of voluntary and regulatory agencies for review activities.

Proficient in collecting and retrieving material from medical records.

Knowledgeable in utilization review, medical terminology, appropriate levels of care, treatment, modalities, statues, and healthcare delivery models.

Interpersonal relationship abilities must be highly refined with negotiation and problem-solving skills at a very high level.

Must possess strong clinical assessment and process skills.

Ability to project a professional image.

Knowledge of regulatory standards and compliance requirements.

Strong organizational, prioritizing and analytical skills.

Ability to make independent decisions when circumstances warrant.

Working knowledge of computer and software applications used in job functions.

CERTIFICATES, LICENSES, REGISTRATIONS

Current, valid, and active license to practice as a Registered Nurse in the state of employment required. Current BLS certification required. CCM/CCDS certification preferred.