Director, Case Management

Director, Case Management Directs the preparation, organization, administration and monitoring of the programs/processes necessary for the operation of the Case Management Department. Directs the coordination and development of the utilization management, discharge planning, and progression of care management in order to promote quality of care, safe transitions in care, and appropriate utilization of resources. MAJOR JOB DUTIES: oDirects the operations of and implements the goals, and objectives of the Case Management Department in alignment with the overall organizational strategy and corporate goals including those related to length of stay (LOS), readmissions, transitions of care and patient engagement. oProvides ongoing assessment and analysis of processes, procedures, and technology and continuously strives for improvement. Possesses the Ability to implement changes to the case management model that improves the effectiveness and efficiency of the services. Maintains statistics, and collects, analyzes and presents to evaluate performance and identify opportunities for improvement. oEstablishes and maintains a customer service approach to building internal relationships including frequent collaboration with Patient Financial Services and external relationships and partnerships including developing collaborative relationships with post-acute care agencies/facilities and contracted payors. oLeads, supervises, mentors and develops Case Management supervisors and staff. Supports efforts to achieve full staff development and professional growth oResponsible for compliance with all federal, state, local and organizational regulations and standards applicable to utilization review and discharge planning and formulates plans for future program development accordingly to support organizational and departmental goals and objectives. oParticipates in strategic fiscal and budget planning to all aspects of the Case Management Department. Plans appropriate use of resources including space, equipment and personnel to obtain optimal utilization and efficiency while containing cost. Monitors operating costs and adjusts budgetary needs to ensure cost containment. oPerforms other related administrative/managerial duties as directed/required including providing leadership and coordination of hospital wide committees including the Utilization Review Committee. oPerforms other duties as assigned. Education: Bachelor's degree Nursing - Required.  Licensure: Current and valid NYS Registered Professional Nursing license - Required. NYS DOH certification as a Patient Review Instrument (PRI) Assessor - Required. NYS DOH certification as a SCREEN Assessor - Preferred. Experience: 6 - 8 Years In-depth experience inclusive of acute care clinical patient care, utilization management, discharge planning, post acute care placement, and insurance denial management.  - Required. 12305133_182887
Salary Range: NA
Minimum Qualification
5 - 7 years

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