Nurse Director Case Management

Overview

• Lead the case management department to enhance patient care and discharge planning in a dynamic healthcare environment.
• Develop strategic initiatives to optimize care coordination and utilization management processes effectively.
• Collaborate with multidisciplinary teams to improve patient outcomes and operational efficiency.
• Provide leadership and mentorship to case managers, social workers, and clinical coordinators.
• Utilize data-driven insights to streamline operations and resource allocation efficiently.
• Ensure compliance with healthcare regulations and organizational policies at all levels.
• Promote continuous quality improvement initiatives to enhance service delivery and patient satisfaction.
• Support professional development and training opportunities for case management staff.

Key Responsibilities & Duties

• Supervise and guide case managers, social workers, and utilization review coordinators in their daily operations.
• Develop and implement policies for effective utilization management and discharge planning.
• Analyze data to identify trends and areas for improvement in case management processes.
• Collaborate with clinical teams to design and execute patient-centered care plans.
• Monitor compliance with utilization review criteria and standards to ensure quality care.
• Lead initiatives to enhance patient satisfaction and reduce hospital readmissions effectively.
• Ensure accurate and timely documentation of case management activities and outcomes.
• Provide training and mentorship to staff, fostering professional growth and excellence.

Job Requirements

• Bachelor of Science in Nursing (BSN) required; active CA Registered Nurse license mandatory.
• Minimum 5 years of experience in case management; 7 years preferred.
• Proficiency in Milliman and InterQual criteria for utilization review preferred.
• Strong analytical skills for problem-solving and data evaluation essential.
• Knowledge of basic to intermediate computer skills required.
• Current Basic Life Support (BCLS) certification preferred.
• Demonstrated experience in leading multidisciplinary teams in healthcare settings.
• Sign-on and relocation benefits available for qualified candidates.