Case Management Director - Ottumwa IA

Position Overview:

The Director of Case Management plays a pivotal role in ensuring the delivery of highquality patientcentered care by leading and overseeing the hospitals case management program. This includes managing and optimizing care facilitation utilization management case management and discharge planning processes. The Director will provide leadership guidance and supervision to Case Managers and Social Workers ensuring compliance with all relevant regulations and standards while fostering a collaborative environment for multidisciplinary care.

Key Responsibilities:

Leadership & Supervision:

• Lead mentor and supervise the daily activities of the Case Management and Social Work teams ensuring high standards of care and efficiency in patient management.
  
• Oversee the hiring performance evaluations scheduling and payroll management for department staff utilizing systems such as KRONOS.
  
• Facilitate daily multidisciplinary rounds promoting collaboration among healthcare professionals to deliver comprehensive holistic care to patients.
  
• Provide ongoing education and development opportunities for Case Managers and Social Workers to ensure continuous professional growth and departmental effectiveness.
  

Case Management & Compliance:

• Implement and manage the hospitals case management program ensuring compliance with regulatory requirements and internal policies.
  
• Monitor and audit the departments documentation and practices to maintain alignment with Joint Commission CMS state and local regulations.
  
• Participate actively in the Utilization Review Committee and Revenue Cycle Committee contributing to the development of quality improvement programs and trending data analysis such as Avoidable Days and Readmissions.
  

Patient Care & Discharge Planning:

• Collaborate with physicians to develop and implement appropriate plans of care assist with level of care determinations and manage bed placement assignments.
  
• Lead the discharge planning process ensuring patients and their families receive the necessary education and resources for a smooth transition from hospital to home or other care settings.
  
• Maintain skills in case management and utilization review to cover patient caseloads as needed ensuring continuous patient care across all areas of the hospital.
  

Resource Management & Utilization:

• Promote the efficient use of clinical resources by ensuring that the appropriate amount of resources is allocated based on patient acuity.
  
• Work closely with the Quality Department and Chief Financial Officer to develop implement and maintain programs aimed at improving patient outcomes and reducing costs.
  

Regulatory Compliance & Standards:

• Ensure that the department adheres to all applicable Joint Commission CMS and state regulations as well as internal policies and professional standards.
  
• Develop and update departmental policies procedures and standards to align with payer requirements and discharge planning regulations.
  

Knowledge Skills and Abilities:

• Strong understanding of Medicare managed care inpatient outpatient and home health care as well as utilization management discharge planning and case management.
  
• Ability to work collaboratively with healthcare professionals across all levels to achieve established goals and improve quality outcomes.
  
• Proficient in performance improvement concepts and strategies.
  
• Excellent communication skills both verbal and written with a demonstrated ability to build effective working relationships with physicians and other healthcare professionals.
  
• Selfmotivated assertive and capable of working independently and as part of a team.
  

Requirements

Qualifications:

Education:

• Graduate of an accredited program of Registered Nursing.
  
• Bachelor of Science in Nursing (BSN) degree preferred.
  

Experience:

• Minimum of two years of experience in case management utilization management discharge planning or related fields.
  
• Two to three years of prior management experience in a hospitalbased nursing setting preferred.
  

Licenses/Certifications:

• Current RN license in the state of Iowa or a multistate license allowing practice in Iowa.
  
• Iowa Mandatory Reporter Child and Dependent Adult Abuse Certificates.