DHR Health

Director - FT - Days - Res Mgmt

DHR Health • $90K — $120K *
Edinburg, TX 78542In-Person
Healthcare
Less than 5 years of experience
More than 3 months ago
Job Overview by Ladders

Qualifications

  • Bachelor's degree required.
  • Strong knowledge of nursing, case management, or healthcare-related field.
  • Certification in Case Management preferred; must achieve within 3 years of hiring.
  • 2-4 years of supervisory experience preferred.
  • Experience in Case Management and Discharge Planning or equivalent required.

Responsibilities

  • Provide leadership, education, and mentoring of Resource Management Staff.
  • Coordinate scheduling, work assignments, and workflow for staff.
  • Participate in hiring and oversee orientation of new staff.
  • Conduct performance evaluations and develop corrective action plans as necessary.
  • Collaborate with multidisciplinary teams to facilitate patient care transitions.

Benefits

  • On-site availability seven days a week for after-hours support.
  • Opportunities for continued education and professional development.
  • Involvement in departmental budget development and quality improvement initiatives.
  • Access to a supportive leadership structure for career advancement.
Full Job Description
DHR Health - US:TX:Edinburg - Days

Summary:

POSITION SUMMARY:

Under supervision of the Vice President of the Integrated Resource Management Department, the Director manages the functions of the Resource Management program. The position is accountable to supervise the daily activities of Resource Management staff and is responsible for other duties as defined by the Vice President. The Director is on-site, available seven days a week and carries a cell phone for after hour, weekend and holidays.

POSITION EDUCATION/ QUALIFICATIONS:

  • Bachelor's degree required
  • Must possess a strong knowledge of nursing, case management or healthcare related field.
  • Certification in Case Management preferred, or must achieve certification within 3 years of hiring.
  • Supervisory experience required, 2-4 years preferred.
  • Previous experience in Case Management and Discharge Planning or equivalent required.


JOB KNOWLEDGE/EXPERIENCE:

  • Requires knowledge in the areas of case management and utilization management. Experience with Managed Care preferred. Knowledge of utilization management as it relates to third-party payers.
  • Experience in use of InterQual and or Milliman criteria and review processes.
  • Knowledge and understanding of Medicare and Medicaid guidelines and regulations pertaining to utilization review and discharge planning.
  • Demonstrated skills in the areas of negotiation, excels in communications (verbal and written), conflict, interdisciplinary collaboration, creative problem solving, and critical thinking. .
  • Knowledge of health care financing, and data analysis.
  • Must have a working knowledge of hospital operations, medical/nursing staff procedures, and hospital and community resources.
  • Requires leadership skills and an ability to interact well across departments, facilities and organizations.
  • Organizational, human relations, and communication skills are required
  • Computer skills required with knowledge of Microsoft Office Suite.
  • Bilingual - English/Spanish preferred.

Responsibilities:

POSITION RESPONSIBILITES:

  • Provides leadership, education, and mentoring of Resource Management Staff.
  • Provides training within the department on topics relevant to the services provided.
  • Coordinates the planning of schedules, work assignments and directs the workflow for the staff.
  • Participates in hiring, and oversees orientation of new staff.
  • Provides/oversees training program of BSW as required by the State of Texas.
  • May be called upon to undertake supervision of students, trainees or staff.
  • At regular intervals reviews pertinent medical records/ logs to ensure that all information is complete
  • Performs evaluations of the staff in concert with the Administrator.
  • Develops corrective actions plans with staff not meeting expectations of their respective position.
  • Reviews policies annually to make sure they reflect current standards and regulations.
  • Participates in the development of the department budget.
  • Represents Resource Management at hospital committee and work groups as requested by the Administrator.
  • In accordance with departmental policy, will be required to attend relevant training courses and staff developmental programs when these are made available and recommended by senior staff/training officers.
  • Maintains personal competencies needed for licensure and attending internal and external educational offerings.
  • Evaluations are completed timely and provide goal setting for the future year
  • Work schedules are completed timely and reflect adequate staffing.
  • Provides leadership functions in absence of Vice President of Integrated Resource Mgt.
  • Review biweekly staffing schedule.
  • Maintains supplies equipment.
  • Requests for PTO.
  • Maintains departmental staffing within established budget.
  • Collaborate with the multidisciplinary team to assure effective, efficient, appropriate care in order to optimize the health status and assure a smooth transition between levels of care for patients served.
  • Manages staff performance related patient's transition through the system and transfers accountability to the appropriate person upon entry into another clinical service or upon discharge.
  • Participates in rounds on nursing units to observe and provide direction so as to facilitate maintain resource consumption.
  • Serves as a resource to associates/physicians/ Case Managers and Social Workers on issues relating to utilization of services and discharge planning.
  • Assists in facilitating and implementing physician orders to aid in the timely completion of patient care along the continuum.
  • Provides training within the department on topics applicable to the services provided
  • Performs quality assessment reviews and studies both concurrently and retrospectively as required by the hospital's PI plan, TJC standards, CMS and third-party payer regulations.
  • Applies generic quality screens/indicators concurrently to patient medical records and accurately abstracts relevant patient care data to determine if quality screens are flagged. Performs first line reviews on potential quality issues as requested by the Administrator.
  • Refers all other potential quality of care issues identified, not reviewed, as part of the quality assessment screening to the physician advisor to facilitate timely follow up.
  • Monitors and oversees avoidable day data for system Performance Improvement
  • Refers quality issues to the Resource Management Administrator, CMO and/or PA appropriately.
  • Identifies and reports opportunities to improve care for patients, including patient complaints and any unusual patient care issues.
  • Assists the Vice President in establishing and maintaining an effective Denial Management Program and process
  • Organize and conduct meetings and training sessions.
  • Member of Denial Management Team
  • Data Management
  • Demonstrate ability to collect, analyze and present data accurately as appropriate to position
  • Prepare clear and concise oral and written reports
  • Organize and provide materials in compliance with laws, regulations and policies
  • Provide at minimum, monthly reports to Leadership, of discrepancies and other data as requested.
  • Maintains current knowledge of case management, utilization management, and discharge planning, as specified by federal, state, and private insurance guidelines.
  • Maintains a working knowledge about the requirements of the payers most frequently seen with the patient population
  • Maintains a working knowledge of the resources available in the community for patients/families.
  • Maintains current nursing licensure CEU credits.
  • Maintains knowledge of InterQual and Milliman criteria.
  • Performs related duties as required

Other information:

LINES OF REPSONSIBILITES:

(Chain-of-command)

1. Director of Resource Management → 2. Vice President of Resource Management

About DHR Health

DHR Health Careers

Joining DHR Health offers an unparalleled opportunity to become part of a dynamic team of professionals dedicated to healthcare excellence. As one of the leading healthcare providers, DHR Health is renowned for its commitment to innovation, leadership, and diversity in the medical field.

Explore Job Opportunities

DHR Health is actively seeking skilled individuals who are passionate about making a difference in the healthcare industry. With a variety of job opportunities available, candidates can find positions that match their skills and career aspirations. Explore employment options that range from clinical roles to administrative positions, each offering a chance to contribute to top-tier patient care.

Experience Professional Growth

DHR Health is committed to the professional growth and continuous education of its team members. The company supports career advancement through leadership training programs, professional development courses, and hands-on experiences that enhance skills and knowledge.

Internship Programs

For those beginning their careers, DHR Health offers internship programs that provide invaluable industry experience and networking opportunities. Interns at DHR Health work alongside experienced professionals, gaining insights that are crucial for future employment in the healthcare sector.

Cultivating a Diverse and Inclusive Culture

DHR Health prides itself on fostering an inclusive workplace where diversity is celebrated. The company's diversity training ensures that all team members can thrive in a supportive and respectful environment. This commitment to diversity strengthens the team and enhances the quality of care provided to patients.

Benefits and Perks

Employees at DHR Health enjoy a comprehensive benefits package that underscores the company’s commitment to their well-being and satisfaction. Benefits include health insurance, retirement plans, and paid time off, among others, designed to support the team both personally and professionally.

Join the Team

DHR Health is hiring! Search open positions that align with your career goals. DHR Health looks for dedicated, curious, and compassionate team players ready to make a significant impact in healthcare. Tailor your resume to highlight relevant experience and skills, and prepare for an interview that could lead to numerous rewarding career paths within the company.

Stay Connected

Keep up to date with the latest at DHR Health by following their career blog. Gain insights from insider perspectives, and stay informed about new job openings and company news. Personalize your subscription to receive job alerts and updates that align with your professional interests.

Networking and Innovation

At DHR Health, networking and innovation are at the heart of the company's success. Employees are encouraged to engage in events and activities that foster professional connections and collaborative innovation, driving forward the mission of delivering exceptional healthcare services.

Career Development

DHR Health is dedicated to the long-term career development of its employees. With support for certifications and training, team members are equipped to meet the challenges of the healthcare industry while advancing their careers.

Explore Careers at DHR Health

Discover the exciting and rewarding opportunities waiting for you at DHR Health. Whether you are just starting your career or looking to make a significant impact in healthcare, DHR Health offers a path for growth and success. Join a team that values leadership, innovation, and a commitment to diversity and excellence in healthcare.
Learn more about DHR Health
Size
1,001 employees
Industry
Hospitals & Medical Centers
* Ladders Estimates

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