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Director of Case Management

Careerbuilder US

This is a Contract position in Los Angeles, CA posted September 27, 2020.

Oversees the activities and functions of the case management department to ensure efficient and cost-effective case management is achieved.

Develops and maintains quality-improvement programs, collaborates with physicians and medical staff to ensure service expectations are being met.

Ensures effective utilization of hospital resources, appropriate reimbursement for services rendered and supports efficient patient throughput.

Directs the workflow of other case managers and develops department policies and procedures.

Essential Functions:
– Directs, coordinates and monitors the activities, functions and performance of care coordination to ensure a high level of quality case management and cost effectiveness.

– Designs, implements and monitors systems for effective pre-admission screening, admission monitoring, concurrent and retrospective utilization review, discharge planning and social work.

– Develops and monitors an environment that supports experience in personalized patient case management services by leading and directing implementation of the efficient movement of the patient through the continuum of care, utilization case management principals of care coordination, transition planning and utilization management.

– Acts as a resource who provides interpretation, expertise and advise regarding case management issues for patients, legal and federal and state regulations.

– Works within broad guidelines; applies advanced technical knowledge of multiple departments to solve complex problems which may have long-term impact on the department.

– Performs other job-related duties as assigned.

Job Requirements: Education:
– Bachelor’s Degree or equivalent combination of education/related experience: Required
– Master’s Degree: Preferred Work Experience:
– Seven years experience: Preferred
– Five years leadership experience: Preferred Required Licenses/Certifications:
– Registered Nurse (RN) licensure in the state of practice: Required
– Case Management certification: Required