Director of Case Managment
Director of Case Managment
Posted on :
20-12-2024
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1 Vacancy
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Job Description
Director of Case Management
Location: USA Rutherfordton
Experience: 3 25 Years
MustHave:
Associates Degree in Nursing required
BLS Certification required
Current RN license to practice in NC (NC licensure or multistate (compact) license).
CCM Certification completion within 1st year of employment or transfer to the role.
Minimum Education:
An Associates Degree in Nursing requires a Bachelors Degree in Nursing or a Masters Degree in a related field preferred.
Current RN license to practice in NC (NC licensure or multistate (compact) license).
Required Skills
Certifications: BLS required ACMA Certification PreferredCCM Certification completion within 1st year of employment or transfer to the role.
Requires critical thinking skills decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.Comprehensive knowledge of care management and discharge planning Medicare and Medicaid admission and review requirements and general commercial admission and review requirements.Working knowledge of Interqual criteria.Working knowledge of finance and budgetary process and government billing regulations.Effective communication skills especially with medical staff.Knowledge of Conditions of Participation and Joint Commission standards. Excellent customer service and presentation skills are a mustStrong interpersonal and written communication skills are essential Demonstrated ability to apply analytical and problemsolving skills demonstrated ability to manage multiple tasks or projects effectively Ability to work independently as needed with a high degree of detail orientationCapable of planning and organizing projects with short noticeAbility to work efficiently in a fastpaced environment
Minimum Work Experience
Minimum 3 years RN experience (acute care) and or Care Coordination experience required. Minimum 3 years of management experience preferred.
Benefits Wide range of benefits options!
Here at Rutherford Regional you choose your own Medical Dental and Vision plans from a variety of competitive options that give you the coverage that best fits your needs.
- HSA
- 401(K) retirement plan contributions
- Generous Paid Time Off
- Accident & Critical Illness Insurance
- Prescription Assistance with OptumRx
- Income protection programs for the entire family such as life insurance Short/Longterm Disability and Identity Theft.
- Employee Assistance program at no cost to you to provide emotional legal financial and daily life support for your entire household. Services are available 24 hrs. a day 7 days a week.
- Free travel and entertainment discount program to ensure you enjoy your time away from work.
Job Description:
The Director of Case Management is responsible for the oversight of Case Management unit including but not limited to clinical resource management discharge planning activities patient advocacy clinical social work and best practice in medical necessity determination and concurrent review. Accountable for the execution adaptation and outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources appropriateness of care and adherence to a designated Geometric Length of Stay (GLOS) for each patient.
Essential Functions:
The Director is responsible for the overall direction and management of these areas including planning organizing and directing all activities staffing performance improvement in the delivery of clinical services (such as LOS reduction) and reporting needs within the RRHS as well as government and regulatory reporting.
The Director guides Care Coordination activities according to the needs requirements and policies of RRHS the affiliated medical groups and health plans and any Federal and State agencies and according to standard practices of the professions under the directors accountability.
The Director will consult and collaborate with other managers physicians administration and communitybased healthcare workers regarding care management issues identified through corporate or facility initiatives and current literature.
This position will work closely with all departments at the medical center and the postacute service providers to streamline the patient transition through the healthcare system and into the community postdischarge.
The Director participates regularly in RRHS Service Area or Corporate meetings pertinent to the accountable areas and also participates in corporate strategic planning and performance improvement teams and programs as necessary.
This position requires the full understanding and active participation in fulfilling the Mission of the Organization. It is expected the director will demonstrate behavior consistent with the Core Values of the organization. It is expected the director will support the Organizations strategic plan and the goals and direction of the Performance Improvement Plan (PIP).
Assists with developing specific departmental goals standards and objectives which directly support the strategic plan and vision of the organization.
Assesses the quality of patient care delivered and coordinates patient care services with patients staff physicians and other departments.
Creates and fosters an environment that encourages professional growth.
Integrates evidencebased practices into operations and clinical protocols.
Works with physicians nurses ancillary staff and social services at the point of care to facilitate multidisciplinary decisionmaking that is consistent with the goals and objectives of the plan of care and the wishes of both the patient and family.
Must understand payer issues with regard to patient management and resulting implications of clinical decisions and anticipate to opportunities to reduce expense and capture revenue appropriately from admission through discharge.
Educates Physicians and staff in Case Management standards and assists them in meeting the regulations and standards as requested by Joint Commission OSHA CMS HCFA AHCA and other regulatory agencies. Educates and mentors all staff in UR standards and LOS topics.
Insures effective Utilization Review Process.
In addition this position considers the population served by RRHS and area clinical integration programs and leads efforts to optimize care coordination across the care continuum. This coordination ensures a plan of care for patients in all states of health needs.
presentation skills,care coordination,performance improvement,critical thinking,discharge planning,analytical and problem-solving skills,customer service,planning and organizing,interqual criteria,judgment,government billing regulations,detail orientation,financial and budgetary process,management,care management,project management,case management,medicare and medicaid regulations,effective communication
Employment Type
Full Time
Company Industry
Key Skills
- Crisis Management
- Marketing
- Public Relations
- Fundraising
- Media Relations
- Constant Contact
- Strategic Planning
- Social Media Management
- Team Management
- Public Speaking
- Wordpress
- Writing Skills
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