Case Management Director
Ottumwa, IA
$93,272 - $125,900
Job Description
GENERAL SUMMARY OF DUTIES – The Director of Case Management’s primary responsibilities include: The manager of case management is responsible and accountable for the implementation of the case management program at the hospital level. The components/roles of the inpatient case management program consist of the following: care facilitation, utilization management, case management and discharge planning.
DUTIES INCLUDE BUT ARE NOT LIMITED TO
· Provide leadership, education and supervision for the day to day workflow of Case Managers and Social Workers.
· Monitor Case Management Department’s documentation to ensure meets regulatory compliance.
· Collaborate with Chief Financial Officer and Quality Department to develop and maintain quality improvement programs and trending of data (e.g. Avoidable Days , Readmissions) .
· Maintain skills in case management and utilization review to allow for coverage of patient caseload to cover staffing needs of all areas of hospital.
· Communicate with physicians concerning patient needs and aid with development of appropriate plan of treatment and assist with level of care and bed placement assignments .
· Directly responsible for personnel actions including hiring, performance appraisals ,employee schedules, and maintain payroll records and time reports in KRONOS.
· Facilitate daily Multidisciplinary Rounds to provide collaboration with other disciplines to provide holistic patient care.
· Participate in discharge planning. Provides necessary education and resources to meet the discharge needs of individual patients and families.
· Active participant of Utilization Review Committee and Revenue Recycle Committee.
· Promote efficient utilization of clinical resources.
· Promotes the appropriate amount of resources are used based on patient acuity.
· Assures appropriate level of understanding, awareness and compliance with all applicable Joint Commission, CMS, state and local agency laws, internal/external regulations, guidelines, policies, procedures and professional standards.
· Other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES
· Working knowledge of payer requirements and discharge planning regulations that support the effect for the development of departmental policies, procedures and standards .
· Working knowledge of Medicare, managed care, inpatient, outpatient and home health continuum, as well as utilization management , discharge planning and case management .
· Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
· Working knowledge of concepts of associated with performance improvement.
· Self-motivated, proven communication skills, assertive, able to work independently and as a team member.
· Demonstrated effective working relationships with physicians.
EDUCATION
· Graduate of a program of Registered Nursing.
· Bachelor of Science in Nursing degree preferred.
EXPERIENCE
· Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program.
· Two to three years previous management experience is preferred with minimum of two years’ experience in hospital- based nursing.
CERTIFICATE/LICENSE
· Iowa Mandatory Reporter – Child and Dependent Adult Abuse Certificates
· Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa