POSITION SUMMARY
Responsible for the direction of staff and fiscal resources of the Case Management Dept. Provides oversight of the hospital Case Management program.
- Provides direction and planning for physician advisor, and staff to establish priorities identifying trends. Develop short- and long-term goals for cost containment and reduction of LOS and utilization of hospital resources.
- Provides direction and planning for physician advisor, and staff to establish priorities identifying trends. Develop short- and long-term goals for cost containment and reduction of LOS and utilization of hospital resources.
- 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.
- Directs utilization review activities for the hospital, interfacing with external payers and review companies to determine appropriate medical necessity of admissions and continued hospitalization.
- Resolves conflicts related to discharge planning with patients/families, external and external payers.
- Facilitates transition of patients/families across the continuum by establishing relationships with appropriate providers and community services
- Ensures compliance with DNV standards for the Continuity of Care function.
- Participates as a member of DNV Task Force.
- Establishes effective relationships with external agencies providing services to the organization (such as vendors, care providers, etc.)
- Effectively audits and monitors areas of responsibility for compliance issues. Promptly follows up on compliance issues. Creates an environment that encourages staff to report/resolve complicated issues.
- Employee is dependable and completes other assigned duties on schedule and these duties do not have to be redone.
QUALIFICATIONS
- Must be a graduate of an Accredited School of Nursing with a current La State Board License
- RN Case Management experience in an acute care setting preferred.
- Previous supervisory experience preferred.
- A current Louisiana license is required
- Computer skills preferred.
Please indicate whether you have ever been convicted of a crime, including any misdemeanors and/or DUI/DWI. (Criminal conviction(s) will not automatically exclude you from consideration for employment).
