Summary: The Project Case Management Director serves as interim CMD for any CHS hospital in a selectregion that is without a Case Management Director (CMD) or with a CMD that maybenefit from mentoring. Responsible to assist with the interviewand selection process and the training, mentoring and development of the newlyhired case management director in same facility. This positionreports directly to the Vice President of Case Management & Appeals at thecorporate office and may be asked to assist with various case managementprojects when not engaged at a hospital.
Essential Duties and Responsibilities: include the following
- Directs, supervises, and evaluates the operations of the Case Managementdepartment including, at a minimum, processes of utilization review, dischargeplanning, readmission reduction, and denials avoidance, ensuring thatoperations are effective, timely, and compliant with regulatory and nationalpractice standards
- Develops, implements, and evaluates the Case Management program to ensure quality patient care consistent with the hospital and corporate missions.
- Effectively communicates department goals and measures of success. Communicates effectively with hospital and CHS leadership.
- Promotes and maintains positive relations with patients and their families as well as other healthcare organizations
- Educates staff atall levels about effective case management. Provides this education through both formal and informal methods
- Maintains complete and accurate records of assessments, financials and budgets of the Case Management Department
- Evaluates andpromotes staff competence
- Clearlyidentifies issues that have an adverse effect on clinical and financialoutcomes; actively seeks to resolve issues brought forward by medical staffthat have an adverse effect on patient outcomes
- Mentors new orexisting CMD using evidence-based methods that encourages the CMD to do theproblem solving and analysis
- Possesscomprehensive knowledge of the healthcare industry, familiarity with governmentregulations, healthcare plans, strategic planning skills and an understandingof the operations of a healthcare organization
- Ability to establish and maintain effective workingrelationships with hospital staff, physicians, patients, patient's families,and community
- Demonstrated ability to communicate effectively in personand via telephone with patients, families/caregivers, and physicians usingappropriate dialogue and customer services competencies
- Ability to maintain confidential information concerningpersonal, financial, or medical matters
- Abilityto perform multiple activities, meet deadlines, solve problems, utilizeresources, make independent decisions
- Bachelor's degree in Nursing or Master's degree in Social Work required, Master's degree in Nursing preferred.
- Minimum of 5 years demonstrated successful leadership in case management in an acute-care hospital setting required
- Recent experience in a for-profit acute care hospital within a hospital system and/or case management leadership experience across multiple acute care hospitals preferred.