Director of Case Management
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About The Position
The Director of Case Management at Kindred Hospital Brea is a pivotal role responsible for directing the Case Management and Utilization Management activities within the hospital. This position oversees the facilitation of care coordination for patients and their families, ensuring that quality clinical services are delivered effectively. The Director acts as a patient and family advocate, working closely with external customers, referral sources, and payors to streamline the discharge planning process. This role is also accountable for the facility's denial management program, ensuring compliance with the Conditions of Participation and other regulatory standards. In this capacity, the Director will collaborate with the hospital's executive team, including the CEO, COO, CFO, and CCO, to ensure that case management services align with the hospital's strategic goals. The Director will oversee the coordination of patient care, facilitating the development, monitoring, and refinement of treatment plans. Regular reporting of case management performance outcomes is essential, as is the representation of Kindred Hospitals to the provider community and local educational institutions. The Director will implement and monitor processes to optimize resource utilization and reimbursement, participate in the Utilization Management Committee, and identify opportunities for achieving hospital goals based on comparative data and benchmarks. Additionally, the Director will aggregate and analyze hospital utilization statistics, recommending corrective actions as necessary, and ensuring compliance with CMS, state, and JCAHO regulations and standards, including documentation and record requirements. Active participation in surveys and audits is also a key responsibility of this role.
