POSITION SUMMARY:

Under general direction, the Director of Case Management will direct the case management program, including the functions of case management, utilization management, and discharge planning for the Hospital.The Director of Case Management is responsible for coordinating those systems necessary for safe and appropriate discharge as well as utilization management practices that meet all corporate, facility and regulatory guidelines.The director assesses and evaluates the care/services rendered, staffing levels, competency and educational needs of the case management staff and effectively coordinates and controls resources.The Director provides consultation and education to facility leadership, clinical and financial personnel, the Board of Trustees, and medical staff members related to case management including utilization management and discharge planning practices.The Director oversees the annual review of the Case Management/Utilization Management Plan of the hospital.The Director will identify and implement processes that support and promote efficient patient throughput across the HealthCare continuum resulting in optimal clinical outcomes, appropriate utilization of resources and appropriate & accurate reimbursement.



Qualifications

Education:

Minimum AND, BA or BSN degree in nursing or other healthcare related field.



Experience:

Five (5) years of healthcare experience with two (2) years of Director or Supervisory /Management experience required. Healthcare regulatory and accreditation requirement experience required.



Skills:

Excellent communication skills, positive attitude with excellent customer service skills. Advanced knowledge of levels of care criteria; strong leadership skills. Good financial management. Strong knowledge of regulatory standards for federal payors, JCAHO, and other insurance companies.



Licensure:

Maintain professional licensure as appropriate to discipline.

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