A day in the life…OF THE DIRECTOR OF CASE MANAGEMENT
- Reporting to the VP of Quality and Case Management, is responsible for the overall strategic and operational management of the department,.
- Leads and oversees the department including utilization review, case management, discharge planning, clinical documentation integrity and improvement, and social services through recruitment, development, and retention of high caliber team members.
- Collaborates with staff, clinical leadership and financial leadership to identify and communicate opportunities to improve patient care, social services and outcomes in a fiscally responsible manner. Directs the Case Management model and support at the point of service, improving efficiency and effectiveness of the delivery of care (i.e. LOS, cost reduction, and readmission prevention). Ensures best practice in medical necessity determination and concurrent review activities.
- Identifies and achieves optimal targeted financial outcomes via all Case Management processes through the collection, analysis and reporting of quantitative and qualitative data as it relates to utilization management and care coordination activities. Makes data-driven decisions and implements performance improvement strategies.
- Assures compliance with all regulatory standards regarding required utilization and resource stewardship activities. Collaborates with medical, administrative and clinical staff to develop systems that improve processes and patient outcomes. Serves as a resource to Patient Financial Services, Revenue Cycle Services, Managed Care, and Patient Access.
What we need (requirements)…
- EXPERIENCE:3 to 5 years Utilization Management and/or hospital-based case management experience preferred
- Required: RN (Registered Nurse) State of Missouri /Bachelor's Degree in Nursing;
OR Master’s degree in Social Work or Healthcare Administration required , CCM (Certified Case Management) within 2 years of hire
- 2 to 3 years previous supervisory experience preferred
What we ask for (preference)…
- Preferred: Masters - Nursing or Master of Social Work or Healthcare Administration