Director of Case Management

Post Acute Medical   •  

Beaumont, TX

Industry: Managed Care & Health Insurance


5 - 7 years

Posted 372 days ago


The Director of Case Management is responsible for managing an outcomes-based case management program that integrates clinical and financial aspects in the assigned areas of the System. The case management process spans the continuum of care in the facility or clinic and returns clients to their optimal lifestyle while achieving efficient and effective delivery of coordinated care and reimbursement.  



  • Nursing, case management, or other health care profession experience of at least five to ten years and demonstrated expertise with quality assurance and compliance standards and process, rehabilitation, insurance, managed care, workers compensation, and outcomes
  • Experience in supervisory and management principles of health care employees
  • Management or supervisory experience of Healthcare Personnel for a minimum of five years
  • Demonstrated experience and competency in working with individuals and groups
  • Application of counseling skills in interpersonal behaviors and conflict resolution
  • Previous experience in marketing, presentation, or sales

Knowledge, Skills, and Abilities

  • Knowledge of TJC requirements
  • Knowledge of quality assurance, standards compliance, and outcome management
  • Knowledge of external medical case management programs
  • Knowledge and application of reimbursement guidelines
  • Knowledge of payment/reimbursement systems
  • Knowledge of patient rights and commitment to patient advocacy
  • Effective educator skills
  • Excellent written and oral communication skills
  • Effective crisis management skills
  • Effective team leadership skills
  • Ability to collect, document, and analyze data
  • Understanding of claims submission process
  • Word processing and data entry skills
  • Network access to community, state, and national resources and health services organizations
  • Application of budgetary skills
  • Ability to effectively manage staff
  • Ability to prioritize and work in concert with the facility CEO and medical staff
  • Ability to assist in training activities
  • Demonstrates effective resource management

Education and Training:

  • Must hold current License as a Registered Nurse (RN) asrequired by the state in which the facility resides and possess related experience to assess clinical and psychological needs and interface with provisional staff, both external and internal.

ID 2017-9448