1. Works collaboratively with the Administrative Officers in developing Case Management strategy and annual goals.
2. Aligns Case Management & Social Work services to meet the terms of Managed Care agreements, Medical Staff needs, Govt. agency regs, & hospital staff. Works collaboratively with departments directly involved in the authorization process & the flow of patient information, i.e. Call Center, Pt. Reg., HIM, PASC, etc.
3. Maintains working knowledge of Medicare/Medicaid regulation as well as trends in Utilization management, and leads department to ensure compliance. 4. Leads the Case Management department in the development and application of quality management and cost reduction strategies throughout the hospital.
5. Assumes responsibility for communication and education regarding case management activities in the organization and the community and serves as a resource.
6. Responsible for and provides direction to Case Management, Social Work, with emphasis on Quality Care and Customer Satisfaction. 7. Leads the Case Management Department within defined financial parameters.
EXPERIENCE Required – Leadership, communication and interpersonal skills and thorough understanding of quality management theory and process. Preferred – Recent hospital leadership experience.
EDUCATION Required – RN with current Virginia State license. A plan in place to attain Bachelor’s degree in a health related field. Preferred – Master’s degree in a health related field.
Job Code: 00035-44176