Job Summary

Case Management Director-RN oversees a staff of case management RNs, LPNs, Social Workers, and/or Case Management Assistants responsible for patient care coordination, discharge planning, utilization review, and social services. The director ensures alignment of objectives and initiative to support organizational goals. A Case Management Director-RN evaluates patient care data to ensure that care is provided in accordance with clinical guideline and organizational standards.

Responsibilities

• Oversees transition management and discharge planning to promote length of stay, care coordination, and patient flow.
• Ensures consistency in workflows, documentation, quality, and outcomes of the department.
• Participates and supports readmission reduction strategies.
• Contributes to overall quality, patient satisfaction, and financial goals.
• Works with medical staff, nursing, administration, and other disciplines to improve care, reduce waste, increase efficiency, and achieve optimal outcomes.
• Supports revenue cycle activities supporting utilization review, medical necessity, payor requirements, and denial prevention.
• Ensures compliance with state and federal regulatory requirements, TJC accreditation standards, and CMS requirements.
• Accountable for budgeting and financial performance of the department.
• Interviews, hires, trains, and supervises of all employees of the department.
• Provides opportunity for professional growth through continued education and training.
• Performs other duties as assigned while supporting the mission, vision, and values to enhance quality, utilization, service delivery, and customer satisfaction.

Specifications

Experience

Minimum Required: 5 years acute care nursing; 2 years of case management

Preferred/Desired: Management experience

Education

Minimum Required: Bachelors Degree as Registered Nurse

Preferred/Desired: Master’s degree as Registered Nurse

Licensure

Minimum Required: Current RN licenses in state which practicing