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Case Management Director
4 months ago
Must-Haves
- Graduate of a program of Registered Nursing.
- Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program.
- Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa
Job Description
GENERAL SUMMARY OF DUTIES The Director of Case Management's primary responsibilities include: The manager of case management is responsible and accountable for the implementation of the case management program at the hospital level. The components/roles of the inpatient case management program consist of the following: care facilitation, utilization management, case management and discharge planning.
SUPERVISES Case Managers and Social Workers
DUTIES INCLUDE BUT ARE NOT LIMITED TO
- Provide leadership, education and supervision for the day to day workflow of Case Managers and Social Workers.
- Monitor Case Management Department's documentation to ensure meets regulatory compliance.
- Collaborate with Chief Financial Officer and Quality Department to develop and maintain quality improvement programs and trending of data (e.g. Avoidable Days , Readmissions) .
- Maintain skills in case management and utilization review to allow for coverage of patient caseload to cover staffing needs of all areas of hospital.
- Communicate with physicians concerning patient needs and aid with development of appropriate plan of treatment and assist with level of care and bed placement assignments .
- Directly responsible for personnel actions including hiring, performance appraisals ,employee schedules, and maintain payroll records and time reports in KRONOS.
- Facilitate daily Multidisciplinary Rounds to provide collaboration with other disciplines to provide holistic patient care.
- Participate in discharge planning. Provides necessary education and resources to meet the discharge needs of individual patients and families.
- Active participant of Utilization Review Committee and Revenue Recycle Committee.
- Promote efficient utilization of clinical resources.
- Promotes the appropriate amount of resources are used based on patient acuity.
- Assures appropriate level of understanding, awareness and compliance with all applicable Joint Commission, CMS, state and local agency laws, internal/external regulations, guidelines, policies, procedures and professional standards.
- Other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES
- Working knowledge of payer requirements and discharge planning regulations that support the effect for the development of departmental policies, procedures and standards .
- Working knowledge of Medicare, managed care, inpatient, outpatient and home health continuum, as well as utilization management , discharge planning and case management .
- Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
- Working knowledge of concepts of associated with performance improvement.
- Self-motivated, proven communication skills, assertive, able to work independently and as a team member.
- Demonstrated effective working relationships with physicians.
EDUCATION
- Graduate of a program of Registered Nursing.
- Bachelor of Science in Nursing degree preferred.
EXPERIENCE
- Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program.
- Two to three years previous management experience is preferred with minimum of two years' experience in hospital- based nursing.
CERTIFICATE/LICENSE
- Iowa Mandatory Reporter Child and Dependent Adult Abuse Certificates
- Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa
Info about position
Background
Title: Case Management Director
Level: Executive
Reports To: CFO
Vacant Since: This is a newly opened position
Vacancies: 1
Travel Required: Travel not required
Visa Support: No visa sponsorships supported
Location(s): in-person
Country: United States of America
City: Ottumwa
State: IA
Postal Code: 52501
