Sr Director Case Management

Inova Health System•Falls Church, VA

9h•Onsite

About The Position

The Senior Director of Case Management for Inova Health System's Fairfax Hospital directs the operations of Case Management while leading and coordinating key strategic developmental and functional services to support department objectives and organizational goals. Maintains effective and responsive relationships with patients, attending medical staff and other departments. Manages department finances including budgeting, control of salary/non-salary and capital investment expenses. Manages staff through daily supervision, team member relations and staff development.

Requirements

Certification - -Basic Life Support (BLS) upon start; Must have 1 of 3 listed below within 12 months of hire:-Certified Case Manager (CCM)-Accredited Case Manager (ACM)-Certified Managed Care Nurse (CMCN)
Licensure - Licensed Registered Nurse or Social Worker in the Commonwealth of VA upon start.
6 years of experience in overall leadership management.
Bachelor's Degree

Nice To Haves

Master’s degree in Nursing, Social Work, Healthcare Administration, or a related field
Active certification Certified Case Manager (CCM), Accredited Case Manager (ACM), or Certified Managed Care Nurse (CMCN) at time of hire
8–10+ years of progressive leadership experience in Case Management within an acute care or large health system environment
Experience in a multi-site or matrixed healthcare system preferred

Responsibilities

Responsible for leading, Social Work and RN Case Managers in the duties transition planning and the coordination of utilization review and denial prevention with our System Revenue Integrity team.
Oversees the day-to-day operation of all Case Management related activities to include the preparation, distribution and interpretation of monthly reports on productivity and case management targets.
Accountable for the management, measurement and continuous quality improvement, transition delays, and the integration of services with the Ambulatory Case Management team.
Ensures that department and functional operations are in full compliance with accrediting and regulatory agency standards.
Oversees the maintenance of case management database and use of case management software.
Responds promptly to requests from other departments within the operating unit and maintains cooperative relationship with corresponding department(s) at other operating units.
Collaborates with other departments and initiates performance improvement activities as appropriate to improve working relationships and patient experience.
Coordinates and monitors the development of long range plans and annual budgets for Case Management department.
Monitors financial performance to ensure it meets budgeted revenue/expense ratios.
Manages reimbursement and contract issues through collaboration with managed care contracting, manages day to day operations of all referral, authorization and intake activities.
Selects, hires, and trains staff to perform assigned functions at a competent level to include Case Managers and Administrative staff.
Designs and implements staffing plans and assignments based on productivity and business needs.
Establishes performance expectations and provides direction, feedback, and guidance to employees.
Completes performance evaluations, employee relations, and needed disciplinary activities.