Director of Case Management RN

Mission Regional Medical Center•Mission, TX

1d•Onsite

About The Position

We are seeking an RN Director of Case Management, also referred to as our RN Director of Clinical Case Management or RN Director of Case Management & Social Services. Our RN Director of Case Management oversees the development and operation of a comprehensive case management program to ensure efficient, high-quality patient care. This role provides leadership and supervision to case managers, social workers, coordinators, and discharge planners while aligning services with the hospital’s mission and the needs of patients and families. The RN Director evaluates program effectiveness and integrates services using continuous quality improvement strategies to enhance outcomes and performance. Mission Regional Medical Center is a 297-bed, non-profit hospital that provides inpatient and outpatient hospital services to the people of the Rio Grande Valley. Rated one of the top hospitals in the country for clinical excellence in many services including maternity and orthopedic care, Mission Regional Medical Center has been offering quality healthcare, close to home, for over 60 years. For more information visit www.missionrmc.org.

Requirements

Starting April 1 2015 Minimum 5 years post graduate of an accredited school of nursing and a currently state Registered Nurse license.
Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school of Social Work for Licensed Clinical Social Worker and/or Doctorate in Related Field.
Required to have a minimum of 5 years experience in a Case Management position.
Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
Current BCLS (AHA) certificate upon hire and maintain current.
Experience and knowledge in basic to intermediate computer skills.
Current Behavioral Violence Prevention Training within 3 months of hire and maintain current.

Nice To Haves

Certification in Case Management, BS or BSN or related field preferred.
Knowledge of Milliman Criteria and InterQual Criteria preferred.

Responsibilities

Lead and oversee RN case managers and social work staff to ensure effective care coordination and discharge planning
Monitor patient length of stay, utilization review, and denial management to support financial and operational goals
Collaborate with physicians, nursing leaders, and interdisciplinary teams to improve patient outcomes and throughput
Ensure compliance with CMS, Joint Commission, and hospital regulatory standards
Facilitate communication and collaboration between nursing staff, hospital leadership, other departments, patients, and families while participating in relevant hospital committees
Develop and implement policies, quality initiatives, and performance metrics for care management services