Position Description

Department Name:

Care Management Department (CMD)

Employee Name:

Job Title:

Director of Care Management

Effective Date:

Reports to (Title):

Director of Nursing

Supervises:

Case Management, Utilization Review, Discharge Planning, Social Services, Mental Health Services, Patient Care Coordination/ Navigation

1. Position Summary:

This role ensures high-quality care coordination while meeting organizational standards, balancing clinical and financial concerns, and prioritizing patient-centered outcomes.

II. Position Requirements:

1. Licensure/Certification/Registration:

1. Education: Bachelor's degree in health and human services (e.g. Social Work, Psychology, Nursing, etc. ). Public Health Administration or related field required.

1. Experience: Five or more years' experience in a management position in a healthcare setting

• Key Responsibilities: Oversee and guide a team of case management, utilization review, discharge planning, social services, mental health services, and patient care navigation, ensuring efficient patient care coordination.
• Cultivate a high-performance collaborative culture by providing intentional mentorship and coaching to direct reports that encourages continuous learning, autonomy, and successful performance goal outcomes.
• Develop and implement care management programs, including utilization review, discharge planning, care coordination, and patient navigation.
• Assess patient care data to confirm adherence to clinical guidelines and organizational standards.
• Seek treatment plans that align clinical goals with financial considerations, family needs, and patient quality of life.
• Collaborate on organizational and departmental goals, focusing on service quality, employee engagement, and financial performance.
• Provide evaluation of program operations and services as measured by specified quality protocols and remediation plans.
• Build partnerships with other organizations to further the reach and impact of our programs.
• Participate in statewide and community meetings, events and conferences reporting relevant information back to the team.

1. Required Knowledge & Skills

• Experience with person-centered planning principles and addressing barriers to community discharge.
• Demonstrated ability to supervise and motivate staff, mediate conflicts, and solve complex problems.
• Strong oral and written communication skills. Ability to explain complex ideas in a way that is easy to understand and convey the importance of work. Able to listen to feedback and answer questions from others.
• Competence in Microsoft Office including Outlook, Word and Excel; ability to oversee digital tracking systems
• Maintain strict confidentiality regarding participants, personnel matters, and agency business in accordance with HIPAA and agency policy
• Demonstrated ability to gather information, evaluate it and make decisions based on the information you have.
• Determine the success of programs and make changes for improvement. Evaluate program needs, develop and implement strategies to meet the needs.
• Demonstrated ability to manage multiple projects at once, including creating a project plan, assigning tasks to team members, monitoring the project progress and evaluating the project success.
• Demonstrated ability to build and maintain relationships with a wide array of people from diverse backgrounds.

1. This job description is not intended to be all inclusive, and employee will also perform other reasonably related duties as assigned by immediate supervisor

1. Special qualifications: Must possess a valid Driver's License, current automobile insurance, and reliable transportation.

III. Degree of Supervision Required: Yes

IV. Ages of Patients Served: This position has no responsibility to treat or care for patients.

This position requires competence in assessment, treatment, and/or care for the age groups indicated. The staff member must be able to demonstrate the knowledge and skills necessary to provide care, based on physical, educational, safety, and related criteria, appropriate to the age of the patients served in his/her assigned service area. The skills and knowledge needed to provide such care may be gained through education, training, or experience.

Birth - 1 Year

Infant

2-12 Years

Pediatric

13-18 Years

Adolescent

19-69 Years

Adult

70>

Geriatric

N/A

No responsibility to treat or care for patients

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V. Working Conditions:

Hospital rooms, common areas, clinical departments and hospital grounds. Potential hazards include:

Exposure to

None

Some

Frequent

Very Frequent

Exposure to

None

Some

Frequent

Very Frequent
• toxic/caustic

chemicals
• blood or body

Fluids
• extreme

conditions,

hot or cold
• communicable

Diseases
• dust/fumes/

Gases
• unprotected

Heights
• moving

mechanical

parts
• CRT (computer)

Monitor
• potential

electric shock
• frequent,

repetitive motions
• x-ray electro-

magnetic

energy
• Other (as listed)
• high pitched

Noises
• needles or

other sharp

objects

VI. Physical Requirements: Constant: sitting, seeing, hearing, and finger dexterity. Constant concentration in fine details with frequent interruptions. Occasional: pushing, pulling, climbing, bending, stooping, twisting, using arm, leg and back muscles may be required. May be expected to lift less than 25 pounds. Manage stress appropriately, handle multiple priorities. Make decisions under stress. Work along and manage anger, fear, hostility and violence of others appropriately.

VII. Personal Protective Equipment: N/A

VIII. Performance Standards:

Rating Standard

U - Unacceptable Work performance is inadequate and inferior to the standards of performance required for the position. Performance at

this level cannot be allowed to continue.

IN - Improvement Needed Work performance does not consistently meet the standards of performance for the position. Serious effort is needed to

improve performance.

ME - Meets Expectations Work performance consistently meets the standards of performance for the position.

EE - Exceeds Expectations Work performance is consistently above the standard of performance for this position.

O - Outstanding Work performance is consistently superior to standards required for the job.