Director of case management job description

**** $15,000.00 SIGN ON BONUS****

A better team approach

A better result for patients

BE THE CONNECTION.

CASE MANAGEMENT DIRECTOR II

OFFERING $15,000 SIGN ON BONUS!

Here is your opportunity to channel the full extent of your knowledge, skills, ambition, and experience on a daily basis. Inspire our patients to progress each day as you:

• Take responsibility for the day-to-day operations and human resource management of the department of case management.

• Focus on census management, patient-care outcomes and other key care indicators.

• Oversee the interdisciplinary plan of care and the discharge-planning process to ensure effectiveness and appropriateness of services.

• Act as a patient and family advocate to ensure that services are delivered to meet the needs of patients and families, as well as appropriate use of resources.

• Provide training and direction to support case managers striving to effectively complete assigned responsibilities.

• Manage caseloads and interpret regulations, policies, operational procedures and objectives.

• Promote and maintain an inclusive, diverse work environment and culture.

• Ensure that cultural diversity and sensitivity training are part of new-employee orientation on an ongoing basis to meet the needs of the patient population served in the hospital.

Credentials:

• The qualifications to independently complete an assessment within the professional’s specific scope of discipline (such as RN, SW, OT, PT, ST, or rehabilitation counseling) required.

• Active licensure if required by state of employment essential.

• Current CCM® or ACM certification or acquisition within one year of start date a must.

• For nursing professionals: bachelor’s degree in nursing (BSN) with RN licensure required.

• For other healthcare professionals: bachelor’s degree or better required, graduate degree preferred.

• Three or more years of hospital-based case-management experience, including utilization review and discharge planning essential.

• Demonstrated leadership skills required.

Enjoy competitive compensation and benefits that start on day one, including:

• Benefits that begin when you do.

• Affordable medical, dental and vision plans provided to meet the needs of full and part-time employees and their families.

• Generous paid time off that increases with tenure.

• Tuition reimbursement and continuing education opportunities.

• Company-matching 401(k) and employee stock-purchase plans.

• Flexible spending and health savings accounts.

In your role as case management director I, you’ll have an extraordinary opportunity to be the connection between confident leadership and exceptional results for the communities we serve. We invite you to maximize your impressive healthcare background, strong management abilities and relationship-building capacity to guide a passionate, talented team that delivers exceptional care essential to a lasting recovery. Make a more meaningful professional impact with national post-acute care leader Encompass Health.

What Makes Encompass Health Careers Different—and Better:

Working at Encompass Health means being part of something special: A team that is passionate about making an impact on patients’ lives each day. Unlike the typical hospital setting, Encompass Health offers you the unique opportunity to walk alongside patients on their road to recovery from stroke, spinal cord injuries, neurological disorders, joint replacements, multiple trauma and cardiac/pulmonary conditions. As you help patients achieve goals and regain independence, you can form significant relationships with them and celebrate the successes they experience along the way.

Our culture of compassion and collaboration is founded on more than just the care we provide our patients; it is expressed in the values we live. We encourage and empower each employee to keep learning and growing by providing the resources to deliver a better way to care. At Encompass Health, you’ll find something decidedly different and more satisfying: A career that is challenging, inspiring and rewarding. Maximize your talent and join a team that is committed to setting the standard for better healthcare with this engaging opportunity:

About Us:

Helping patients regain hope and independence, Encompass Health is a national leader in post-acute care. We operate rehabilitation hospitals and offer home health and hospice care in 36 states as well as Puerto Rico. Following the Encompass Way, we are driven by our core values: We proudly set the standard, lead with empathy, do what’s right, focus on the positive, and remain stronger together.

Realize the powerful difference you can make. Take this opportunity to join our team.

Address: 1355 Independence Drive, Augusta 30901
Schedule: Full-time

RN Under the general supervision of the Corporate Director-Case Management, Regional Director supervises and oversees the operations of the Case Management Department in the designated region of WellSpan Health. Works with hospital, regional, medical group, Population Health, post-acute services and system leadership to support the operational achievement of strategic goals. Helps to identify and works in a team leadership model to develop and maintain departmental operations that are consistent with Health System and Community requirements/needs. Provides leadership regarding future strategic goals and the integration of case management principles throughout the System.
** Concentration on Lancaster/Lebanon inpatient Case Management Departments

Duties and Responsibilities

Executes and coordinates the Utilization Review and Case Management operations at System hospital sites in designated regions and coordinates with Regional leadership, Corporate Case Management Director, and peer Case Management leadership regarding payer contract performance and the function of precertification, concurrent review and denial management.
Oversees analysis of Utilization Review trends and works with hospital leadership to address and solve problems.
Liaisons between third party payers and the treatment team regarding the identified treatment plan in accordance with contractual guidelines or System policy; conducts chart reviews and analysis of UR and compliance reports.
Oversees the acute care function and policy development of case management including Utilization Review, Social Services and care coordination, compliance and regulatory standards.
Manages the Case Management operations staffing and budget in designated region for both inpatient and ambulatory case management functions and coordinates with peer Case Management leadership throughout the System.
Identifies care management programming needs which require case management across the continuum. Collaborates with regional leadership team members on the operations of these programs.
Works with leadership in the WellSpan hospital, Medical Group and Post-Acute services to coordinate case management activities across the continuum of care
Leads strategic goals/ priorities that supports business transformation, population health functions and care coordination in collaboration with the appropriate leadership members.

Qualifications

Minimum Experience:
2 - 3 years
Minimum Education:
Master's Degree
Preferred Field Of Expertise:
Utilization management, case management, or clinical nursing specialty
Required Certification:
Registration and current RN license in PA

At. St. Francis-Emory Healthcare, we recognize that our patients deserve qualified, engaged, and competent healthcare professionals. And we know that our healthcare professionals deserve a working environment that is safe, leaders who are visible and supportive, and opportunities to grow and develop in their chosen disciplines. The heart of St. Francis is in its people, making our hospital a family that only the best are invited to join. If you feel that your skills and compassion fit with our vision for healthcare, we invite you to apply today.

Manages Case Management Department (includes Bed Board/Clinical Intake, Disease Management, Social Services, Discharge Planning, Precertification and Denial management; plans, organizes, and directs all related functions and activities (internal and external); establishes goals, objectives, standards of performance; develops operating policies and procedures; interprets hospital policies, standards and regulations to appropriate staff, patients, medical staff and public.

Evaluates the effectiveness of Case Management services related to reimbursement for inpatient and outpatient services. Coordinates, negotiates, procures services and resources for the management the care of complex patients to facilitate achievement of quality and cost efficient patient outcomes. Looks for opportunities to reduce cost while ensuring the highest quality of care is maintained. Develops clinically based case management, discharge planning, and care coordination to facilitate the delivery of cost-effective quality healthcare through identification of appropriate utilization of resources across the continuum of care.
Minimum Education

X Bachelor's degree or 8 years or more of relevant Case Management experience X Required

X Graduate of a Bachelor's Program in Nursing or must complete within 18 months upon date of hire X Required

X Master's degree or 10 years or more of relevant Case Management experience X Preferred

Required SkillsRequires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

Licenses:Professional Registered Nursing licensure in state of GA.

Minimum Work ExperienceFive (5) years clinical experience preferred.

**Job:** **Please select a valid job field*

**Organization:** **St. Francis Hospital*

**Title:** *Director-Case Management*

**Location:** *Georgia-Columbus*