Director Of Case Management

Overview

• Lead and oversee the Care Management Department, ensuring compliance with Medicare and Medicaid standards.
• Develop and implement care management programs to enhance patient outcomes and operational efficiency.
• Collaborate with executive leadership to align departmental goals with organizational strategies.
• Manage departmental budgets and ensure cost-effective solutions for care delivery.
• Provide leadership and direction to a multidisciplinary team of case managers and social workers.
• Ensure compliance with State and Federal regulations and reporting requirements.
• Foster adoption of clinical technology and care delivery support systems across various environments.
• Maintain strong critical thinking and prioritization skills to address complex business challenges.

Key Responsibilities & Duties

• Oversee daily operations of the Care Management Department, including personnel management and program development.
• Develop and implement care management frameworks to improve service consistency and reporting.
• Ensure timely and appropriate utilization review and discharge planning processes.
• Collaborate with internal stakeholders to represent care management initiatives effectively.
• Monitor delegated clinical functions and ensure proper management of care determinations.
• Report program effectiveness to regional leadership and local executives.
• Lead and motivate clinical and administrative teams to achieve departmental objectives.
• Analyze complex business problems and apply cost-effective solutions.

Job Requirements

• Bachelor's Degree in Nursing or Social Work required.
• Minimum of 3-5 years of acute care nursing or social work experience.
• At least 2 years of case management or utilization management experience required.
• Minimum of 3 years of leadership experience in a healthcare setting.
• RN or SW License in the state of employment or compact required.
• Case Management Certification preferred.
• Proficiency in Word Processing and cost-effectiveness analysis.
• Experience in length-of-stay reduction and managing similar-sized hospital operations preferred.