Director of Case Management (40 Hours, Days)

Schedule: 40 Hours, Days, Full Time, Benefit Eligible

Summary:

The Director of Case Management reports to the VP of Finance. Direct reports include Social Work Team Lead, Acute RN Case Managers, Acute Social Work Case Managers, and Administrative Coordinators.

Director of Case Management develops, implements, and evaluates the strategic plan for the hospital's Case Management process. Collaborates with all disciplines with a specific focus on tangible outcomes related to improved quality, patient/provider satisfaction, and decreased costs.

Responsibilities:

• Establishes, implements, and evaluates a strategic plan for the department that takes into account internal and external factors.
• Effectively communicates the plan throughout the organization.
• Creates data priorities and report formats that display critical outcome factors, and reviews findings with the Executive Team.
• Establishes appropriate staffing levels, assignments, and deployment for the department.
• Establishes job descriptions and performance criteria for staff members.
• Develops and administers the budget for the department.
• Identifies organizational needs and concerns in payer-provider contracts and contributes to related negotiations.
• Establishes effective relationships with individual physicians, physician groups, and physician organizational structures.
• Develops structures and processes to facilitate participation by physicians, pharmacists, nurses, social workers, and other health professionals in multidisciplinary care planning, care delivery, and discharge planning.
• Establishes effective communication systems and forums with third party payers and the local PRO.

Required Knowledge and Skills:

• 
  Education: BSN required, MSN preferred
• 
  Experience: Minimum of 3-5 years of experience in case management, discharge planning, and/or utilization review experience required. Prior experience in a management or administrative position preferred
• 
  Certification/Licensure: MA RN Licensure
• 
  Software/Hardware: InterQual
• Knowledge of payer requirements and discharge planning regulations that support the effective development of departmental policies, procedures, and standards.
• Demonstrated ability to establish the goals, vision, and overall direction of a department; create and implement departmental standards, systems, staffing plan, and processes; analyze issues and create an effective plan to address them; critically and comprehensively evaluate the department's outcomes; identify, collect, and analyze data related to the internal and external environment as well as departmental functioning; and develop and educate staff.
• Demonstrated ability to communicate verbally and in writing to internal and external constituencies.
• Ability to establish priorities, meets deadlines, and develop and manage the department's productivity standard in the management of the work assignment.
• Ability to form positive, collaborative relationships with members of the executive team, hospital staff, post-acute providers, and payers.
• Ability to problem-solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge.
• Ability to effectively negotiate with internal and external service providers.
• Knowledge of external requirements that impact the department, such as JCAHO and Department of Health.
• Knowledge of information systems to support the evaluation of current capacity as well as future needs.

Equal Opportunity Employer/Disabled/Veterans