Director-Case Management

Case Management Director-RN oversees a staff of case management RNs, LPNs, Social Workers, and/or Case Management Assistants responsible for patient care coordination, discharge planning, utilization review, and social services. Works with medical staff, nursing, administration, and other disciplines to improve care, reduce waste, increase efficiency, and achieve optimal outcomes.

Overview

Job Summary

Case Management Director-RN oversees a staff of case management RNs, LPNs, Social Workers, and/or Case Management Assistants responsible for patient care coordination, discharge planning, utilization review, and social services. The director ensures alignment of objectives and initiative to support organizational goals. A Case Management Director-RN evaluates patient care data to ensure that care is provided in accordance with clinical guideline and organizational standards.

Responsibilities

• Oversees transition management and discharge planning to promote length of stay, care coordination, and patient flow.
• Ensures consistency in workflows, documentation, quality, and outcomes of the department.
• Participates and supports readmission reduction strategies.
• Contributes to overall quality, patient satisfaction, and financial goals.
• Works with medical staff, nursing, administration, and other disciplines to improve care, reduce waste, increase efficiency, and achieve optimal outcomes.
• Supports revenue cycle activities supporting utilization review, medical necessity, payor requirements, and denial prevention.
• Ensures compliance with state and federal regulatory requirements, TJC accreditation standards, and CMS requirements.
• Accountable for budgeting and financial performance of the department.
• Interviews, hires, trains, and supervises of all employees of the department.
• Provides opportunity for professional growth through continued education and training.
• Performs other duties as assigned while supporting the mission, vision, and values to enhance quality, utilization, service delivery, and customer satisfaction.

Specifications

Experience

Minimum Required

• 5 years acute care nursing; 2 years of case management

Preferred/Desired

• Management experience

Education

Minimum Required

• Bachelors Degree as Registered Nurse

Preferred/Desired

• Master’s degree as Registered Nurse

Training

Minimum Required

Preferred/Desired

Special Skills

Minimum Required

Preferred/Desired

Licensure

Minimum Required

• Current RN licenses in state which practicing

Preferred/Desired