Director of Case Management
About The Position
POSITION SUMMARY Responsible for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patient, families and caregivers. Completes established competencies for the position withindesignated introductory period. Other related duties as assigned.
Requirements
- MINIMUM EDUCATION: Bachelor’s Degree from an accredited school, college or university as a Registered Nurse
- MINIMUM EXPERIENCE: 2 years in acute hospital case management, healthcare or leadership experiences
- REQUIRED CERTIFICATIONS/LICENSURE: Possession of current Texas State registration as a Registered Nurse
Nice To Haves
- PREFERRED EDUCATION: Master’s Degree from an accredited college or university in Nursing or related field
- PREFERRED EXPERIENCE: 5 years in acute hospital case management. McKesson InterQual® experience and Business Planning experience
- PREFERRED CERTIFICATIONS/LICENSURE: Accredited Case Management (ACM)
Responsibilities
- Establishes goals and objectives that support overall strategic plans of the facility/Baptist Health System
- Develops and manages the annual department operating and capital budgets
- Directs daily operations of assigned department/s
- Directs performance of staff
- Maintains objectivity in decision making, utilizing facts to support decisions
- Supports the mission statement, policies and procedures of the Baptist Health System
- Manages to eliminate boundaries to achieve integrated, efficient and quality service
- Achieves ongoing compliance with all regulatory agencies
- Serves as a resource to employees and customers as demonstrated by visibility and knowledge of issues
- Demonstrates flexibility in response to change
- Anticipates and responds to problems and risks
- Communicates effectively with all levels in the organization and with inter/external customers
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What This Job Offers
Job Type
Full-time
Career Level
Director
