Director of Case Management

4 weeks ago

Houston, Texas, United States Scott & Crosby Staffing, Inc. Full time
Job Description

The Director of Case Management is responsible for overseeing the implementation of the case management program at the local level. This role involves developing systems and processes for care/utilization management and discharge planning at the hospital level.

The Director is responsible for managing the department's activities related to discharge planning and clinical quality improvement. They evaluate and ensure that hospital resources are used appropriately and effectively.

The Director oversees the collection, analysis, and reporting of financial and quality data related to utilization management, quality improvement, and performance improvement.

Key Responsibilities:

  • Plans, directs, and supervises all aspects of the local level program.
  • Facilitates growth and development of the case management program consistent with enterprise-wide philosophy and in response to the dynamic nature of the healthcare environment.
  • Responsible for approving and managing the day-to-day local level operational budget.
  • Assures that revenue, expenses, contribution margin, and FTEs meet or exceed budget.
  • Prepares and submits budget and related reports.
  • Forecasts and accurately projects expenses.
  • Takes corrective action to address negative variances.
  • Identifies and proposes capital budget items appropriately.
  • Identifies and achieves optimal targeted financial outcomes via the inpatient case management process.
  • Responsible for departmental personnel functions (hiring, firing, etc.) in conjunction with the Executive Director of Medical Management.
  • Writes and conducts annual and interim performance appraisal reviews for the professional and non-professional staff in the department.
  • Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospitalists, community care managers, nurses, community resources, etc.).
  • Uses data to drive decisions, plan, and implement performance improvement strategies for case management.
  • Oversees the education of physicians, managers, staff, patients, and families related to the case management process at the local level.
  • Participates in this evolutionary process by constantly identifying future needs of current customers and/or identifying potential new customers.
  • Ensures safe care to patients, staff, and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and quality of service.
  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
  • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized, and efficient experiences to patients and colleagues.

Requirements:

  • Minimum Qualifications:
    • Bachelor's of Nursing (BSN) or Master's Social Work (MSW); Master's degree preferred.
    • Current and valid license to practice as a Registered Nurse in the state of Texas or Current and valid Texas license as a Master's Social Worker (LMSW), required.
    • LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM), or Fellowship of the American Academy of Case Management (FAACM), required.
  • Experience/Knowledge/Skills:
    • Minimum five (5) years experience in utilization management, case management, discharge planning, or other cost/quality management program.
    • Three (3) years of experience in hospital-based nursing or social work preferred.
    • 5 years supervisory experience.
    • Self-motivated, proven communication skills, assertive.
    • Background in business planning, and targeted outcomes.
    • Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management.
    • Working knowledge of the concepts associated with Performance Improvement.
    • Demonstrated effective working relationship with physicians.
    • Ability to work collaboratively with healthcare professionals at all levels to achieve established goals and improve quality outcomes.
    • Effective oral and written communication skills.

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