Bachelor's degree required
RN License Required
Job Description and Duties:
The Director of Case Management is responsible for directing all activities within a department. Specific job duties include planning, organizing and directing of all Case Management functions and work-flow (to include Discharge Planning and Pre-Admission services), developing and maintaining appropriate quality-improvement programs, managing payroll, collaboration with physicians and other hospital personnel to ensure customer (internal and external )service expectations are met or exceeded, developing appropriate policies, procedures and processes to ensure the safe, effective, efficient, high-quality healthcare services are delivered. The Director of Case Management serves as a resource for the case management team and other hospital departments, and reports to the CFO.
Other specific duties include:
· Prepare staffing plans and schedules.
· Conduct performance appraisals and evaluate team member competencies.
· Hiring, firing and training Case Management team members.
· Provide targeted training on governmental regulations and reporting requirements.
· Develop and implement programs to optimize patient care and effectively/efficiently manage available resources.
· Manage all inpatient admissions and ‘observation’ placements to ensure appropriate service setting.
· Ensure Discharge Planning functions are performed effectively to minimize unnecessary hospital stays/days.
· Promote and maintain positive relations with patients, their families, other healthcare organizations and external vendors.
· Other duties as assigned.
Required Skills & Abilities : The Director of Case Management must have;
· An in-depth understanding of healthcare principles and practices, hospital operations, the hospital Revenue Cycle, governmental and other 3 rd -party payers’ processes,
· Significant knowledge of federal and state healthcare regulations along with fluency in the compliance with regulatory standards governing healthcare delivery and payment for services.
· Skilled user of Interqual Criteria and Milliman & Robertson care guidelines.
· Excellent critical-thinking, problem-solving and analytical skills.
· Excellent Customer-focused attitude.
· Solid experience managing, leading and motivating team members and others.
· Proficiency with computers / talented at data-mining, first-level research and analysis.
· Solid small- and large-group presentation skills.
· Initiative (be a self-starter, hands-on and results-oriented) and an ‘agent for change’.
· Ability to create and manage budgets.
Required Education, Training and Experience : The Director of Case Management must have;
· Current licensure as an RN.
· RN with significant experience in an acute care / clinical setting. 10+ years desired.
· 5 years, minimum, in acute care Case Management.
· 3 years, minimum, in acute hospital ‘management’. Case Management leadership is desirable.
· Bachelor of Science in Nursing (BSN).
· Master of Science in Nursing (MSN), desirable. Other graduate degrees will be considered.