The Director of Case Management develops and implements processes for efficient patient throughput across the continuum of care that optimize clinical outcomes, utilization of resources and accurate reimbursement. Responsibilities include directing all activities within the Case Management/Utilization Review department, developing and maintaining policies and procedures to optimize patient care, managing staffing levels, resources, discharge planning and care coordination, collaborating with physicians and clinical staff to ensure service expectations are being met, and directing the workflow of case managers.
Serves as a resource for the case management team and other departments and promotes and maintains positive relations with patients and their families, as well as other healthcare organizations.
BSN, MSN preferred
Current California RN license and Certification in Case Management (CCM or ACM) preferred
Five years proven management of Case Management/Utilization Management experience in an acute care hospital/medical center environment
In-depth knowledge of healthcare principles, practices, regulatory compliance and regulatory standards governing health plans and patient care
Excellent critical-thinking, problem-solving and analytical skills
Ability to lead and motivate others
Strong self-initiative and interpersonal communication skills
Proficient computer skills and a talent for data analysis
Additional Salary Information: Annual bonus up to 15%, plus excellent benefit package