DIRECTOR - CASE MANAGEMENT (RN)

Responsibilities

• Coordinates, provides oversight and manages the Care Management Department.
• Affords assistance to leadership in developing and maintaining an efficient Care Management program within the context of the current healthcare landscape.
• Develops and implements programs that meet hospital, regulatory, system, and customer needs.
• Ensures programs are current with regulatory requirements.
• Affirms that the RN Care Managers, Social Workers, and Care Management Assistants proactively coordinate care while planning for a quality discharge.
• Provides interdisciplinary leadership to promote collaboration and improve care coordination.
• Engages in negotiations to resolve discharge barriers and improve collaboration/continuum of care/patient safety to avoid unnecessary denials and extended lengths of stay.
• Utilizes best practices and benchmark data to guide the development of program goals.
• Maintains sound department operations that support the fiscal goals of the department, hospital, and system.
• Develops financial projections, prepares and effectively monitors and operates within the approved budget to ensure optimal financial departmental performance.
• Maintains hospital indicators impacted by department and adjusts departmental activities accordingly.
• Interprets LifeBridge Health financial indicators to case management staff.
• Collaborates with leadership to critique and analyze data from regulatory agencies.
• Provides feedback to the interdisciplinary team regarding length of stay and denial.
• Leads the Care Management Department to meet current best practices and develops departmental strategy that supports the division.
• Provides leadership and supervision to departmental personnel to accomplish department and hospital goals.
• Consults with other leaders and organizations to keep informed of trends in healthcare, management, patient care practices, and new initiatives to integrate new concepts and practices.
• Establishes goals and objectives for the department.
• Responsible for directing and blending divisional long-range goals with those of the department and hospital.
• Leads staff in identifying customer needs; ensures integration into departmental and divisional strategic and operational plans and directs good customer relations.
• Ensures staff has access to resources/tools/education to perform their duties.
• Affirms that staff meet professional standards; and that care coordination implements best practice and is positioned to serve the needs of patients while meeting performance objectives.
• Leads the CM team in focus on appropriate utilization of hospital levels of care and resources.
• Ensures that patients are treated in the most appropriate care environment.
• Supports the standardization of managing denials, lengths of stay and patient and employee satisfaction across the system.
• Works collaboratively with customers to identify needs.
• Provides education, mentoring, training and guidance to staff, functioning a role model.
• Serves as liaison to extended care agencies.
• Develops and maintains positive relations with external agencies.
• Initiates inter-agency processes to improve continuum of care and avoid denials and unnecessary lengths of stay.
• Engages in negotiation to resolve discharge barriers and improve inter-agency collaboration.

Qualifications

• 5-7 years of relevant experience;
• Nursing degree or MSW required;
• Current Maryland Registered Nurse (RN) licensure; or Social Worker, Counselor or Psychologist License;
• PREFERRED: Certified Case Manager certification.