Director Case Management

Director Case Management for Pearland Houston TX MustHavesCurrent and valid license to practice as a Registered Nurse in the state of Texas or Current and valid Texas license as a Masters Social Worker (LMSW) requiredLCSW preferred and Certified Case Manager (CCM) Accredited Case Manager (ACM) or Fellowship of the American Academy of Case Management (FAACM) requiredMinimum five (5) years experience in utilization management case management discharge planning or other cost/quality management programThree (3) years of experience in hospitalbased nursing or social work preferred5 years supervisory experience NiceToHavesWorking knowledge of managed care inpatient outpatient and the home health continuum as well as utilization management and case management The Director of Case Management is responsible and accountable for the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation Utilization Management Case Management and Discharge Planning. The Director is responsible for developing systems and processes for care/utilization management and discharge planning at the hospital level. In addition the Director may be responsible for managing the departments activities related to discharge planning and clinical quality improvement. The Director evaluates and ensures that hospital resources are used appropriately and effectively. The Director oversees the collection analysis and reporting of financial and quality data related to utilization management quality improvement and performance improvement. The Director promotes interdisciplinary collaboration fosters teamwork and champions service excellence. Minimum Qualifications Education: Bachelors of Nursing (BSN) or Masters Social Work (MSW); Masters degree preferred Licenses/Certifications:Current and valid license to practice as a Registered Nurse in the state of Texas or Current and valid Texas license as a Masters Social Worker (LMSW) required LCSW preferred and Certified Case Manager (CCM) Accredited Case Manager (ACM) or Fellowship of the American Academy of Case Management (FAACM) required Experience / Knowledge / Skills: Minimum five (5) years experience in utilization management case management discharge planning or other cost/quality management programThree (3) years of experience in hospitalbased nursing or social work preferred5 years supervisory experienceSelfmotivated proven communication skills assertiveBackground in business planning and targeted outcomesWorking knowledge of managed care inpatient outpatient and the home health continuum as well as utilization management and case managementWorking knowledge of the concepts associated with Performance ImprovementDemonstrated effective working relationship with physiciansAbility to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomesEffective oral and written communication skills Principal Accountabilities Plans directs and supervises all aspects of the local level program.Facilitates growth and development of the case management program consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices networking quality management and other activities as needed.Responsible for approving and managing the day to day local level operational budget.Assures that revenue expenses contribution margin and FTEs meet or exceed budget.Prepares and submits budget and related reports.Forecasts and accurately projects expenses.Takes corrective action to address negative variances.Identifies and proposes capital budget items appropriately.Identifies and achieves optimal targeted financial outcomes via the inpatient case management process.Responsible for departmental personnel functions (hiring firing etc.) in conjunction with the Executive Director of Medical Management.Writes and conducts annual and interim performance appraisal reviews for the professional and nonprofessional staff in department.Acts as liaison to facilitate communication and collaboration between all care partners (physicians hospitalists community care managers nurses community resources etc.)Responsible for leading a high performance team of system thinkers who incorporate leadership principles and vision in performing the functions of case management.Uses data to drive decisions plan and implement performance improvement strategies for case management.Oversees the education of physicians managers staff patients and families related to the case management process at the local level.Participates in this evolutionary process by constantly identify future needs of current customers and/or identifying potential new customers.Ensures safe care to patients staff and visitors; adheres to all Memorial Hermann policies procedures and standards within budgetary specifications including time management supply management productivity and quality of service.Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports departmentbased goals which contribute to the success of the organization; serves as preceptor mentor and resource to less experienced staff.Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermanns service standards by providing safe caring personalized and efficient experiences to patients and colleagues.Other duties as assigned.