Job Summary and Responsibilities
As our Director, Care Management, you will provide overall coordination for care management across the acute care continuum, establishing a comprehensive program encompassing case management, utilization review, care coordination, discharge planning, and social work.
Every day you will supervise and coordinate all Case Management Services (acute, rehab, outpatient), including staff education, hiring, performance management, and mentoring. You will manage the departmental budget, oversee productivity, coordinate Utilization Management (UM) committees and reports, serve as a clinical resource, and act as a community liaison with external agencies, providers, and medical staff.
To be successful in this role, you will possess extensive leadership experience in care management, a deep understanding of utilization review and discharge planning, strong financial management skills, and a proven ability to lead, mentor, and collaborate effectively with diverse stakeholders to achieve quality-focused patient outcomes.
- Hires, coaches, mentors, and provides performance feedback to staff on an ongoing basis.
- Oversees CM assignments, considering assignments, census, and patient needs.
- Reviews CM operations and work habits on an ongoing basis to improve CM processes.
- Oversees CQI or PI activities aimed at process and cost containment, including LOS management.
- Uses statistical tools to review data pertaining to UM patterns and LOS, and serves as a liaison regarding Compliance activities associated with UM.
- Responsible for the budget planning process.
Job Requirements
Required
- Bachelor's Degree in Nursing or Master's Degree in Social Work (LMSW or LCSW)
- Current RN or Social Work License (LMSW or LCSW)
- Five (5) years of experience in Nursing or Social Work, three (3) of which include Case Management in a hospital setting.
- Prior supervisory/management experience in Case Management.
- Experince in discharge planning and clinical utilization review.
Preferred
- Master Degree in Nursing, Business, Health Sciences, Case Management, or Public Health
- Experience in acute care setting.
