Provides direction and leadership to the Case Management team to promote delivery of high-quality patient care with an appropriate length of stay and appropriate resource utilization. Facilitates the safe movement of the patient through the acute phase of their hospitalization with appropriate post-acute services. Oversees daily case management operations.

Required Qualifications:
• BSN; Registered Nurse License in New Mexico or Bachelor's Degree in healthcare (or related field) or ADN with ten (10 +) or more years of healthcare experience with prior experience working within a hospital setting, at least five (5) years' experience must be in a leadership position
• Hospital Case Management experience
• Knowledgeable of discharge planning process, reimbursement principles, and InterQual criteria
• Assertive and diplomatic communication skills
• Self-motivated and accountable
• Team Oriented
• Accredited Case Manager certification (ACM) within 2 years of hire

Preferred Qualifications:
• Certified Case Manager (CCM)
• Management experience
• Process improvement certified

Duties and Responsibilities:
• Financial and Strategic Management:
~ Understands health care economics and health care public policy
~ Policy development and implementation
~ Develops annual budget with Director
• Human Resource Management and Leadership:
~ Hires, orients, mentors, and completes performance reviews
~ Committed to all aspects of staff education and development
• Quality and Performance Improvement:
~ Actively participates in departmental and organizational quality initiatives
~ Audits for Quality Assurance and employee feedback.
• Relationship Management and Influencing Behaviors:
~ Exhibits effective communication and negotiation skills
~ Promotes and maintains good working relationships with post-hospital care agencies
• Knowledge of the Healthcare Environment:
~ Articulate federal and state payment systems and regulations, as well as private insurance issues, which affect the organization's finances
~ Understand and articulate organization's payer mix, CMI and benchmark database
~ Knowledgeable in CMS's UR/DCP CoPs and industry standards
• Performs related duties and responsibilities as required.
• All SJRMC Employees are responsible for implementing SJRMC's Service Standards into their activities:

Safety, Courtesy, Effectiveness, and Stewardship

Physical Demands and Environmental Work Conditions:
• Prolonged standing/sitting/walking
• Fast-paced environment
• High level of activity with many interruptions
• Possible exposure to communicable disease
• Repetitive motions (e.g., prolonged keyboard usage)

Sensory Requirements:
• Employee will need to be able to hear:

~ Alarms on equipment/fire alarms/overhead announcements

~ Patients/families verbal discussion

~ Instructions/feedback from other healthcare providers
• The employee will need to be able to see:

~ Focus on close-up and distant objects

~ Have intact: peripheral, vision, and depth perception