RN Director of Case Management - Hospital
Redwood Valley, CA (covering 2 different hospitals 15 minutes away)
$$$ Generous Relocation Package available to attract top-talent from around the Nation! $$$
Your Job Summary:
The Director of Case Management provides leadership for planning, management, implementation, integration and coordination of Case Management, Discharge Planning, and Utilization Review, in support of a highly reputable multi-state hospital system. Support the delivery of the high quality, cost effective patient care through activities based on facility strategic goals and objectives. The Director oversees daily team operations and provides strong leadership through training, coaching, teaching, and managing assigned teams and departments.
Valid, unrestricted state Registered Nurse (R.N.) license and BSN; Master's degree preferred.
At least 4-5 years clinical nursing experience at an acute care hospital.
Around 3-5 years Case Management experience; Certified Case Manager (CCM) preferred.
At least 2-3 years managerial experience and leadership of a Case Management staff within a hospital environment.
Prefer 5 or more years of complex case management experience, ideally with a mix of provider and health plan settings.
Ability to analyze and integrate information and make sound decisions based upon established guidelines.
Resourcefulness as demonstrated by the effective application of professional knowledge to new situations. Possess planning, organizing, conflict resolution, negotiating and interpersonal skills.
Experience in training / teaching staffs to meet operational requirements and goals.
Strong oral and written communication skills; ability to interact with all levels of internal and external contacts.
Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
Oversee discharge planning and utilization review of cases, including those with Medicare, Medicaid, HMO and private coverage. Directs development of specific short and long-range programs and project plans to obtain the facility objectives. Responsible for overseeing patient Length of Stay and observation hours and the Clinical Documentation Improvement (CDI) program. Ensures staff is trained and using Milliman and InterQual Criteria. Coordinates the UR Committee and participates in other related interdisciplinary committees and working groups. Responsible for the planning and coordination of activities of Case Managers, the operational efficiency and effectiveness of the department, as well as major impact on all other hospital areas. Effectively interviews and selects a qualified number of personnel as required to meet department objectives. Ensures hiring practices conform to appropriate Affirmative Action/EEO practices and regulations. Provides direction to the staff and supervisors of Case Management Department. Oversees the prioritization of projects and directs resources to ensure the attainment of facility goals. Responsible for ensuring the department meets and adheres to all applicable federal, state, JCAHO, and local regulatory agency requirements and for ensuring the department and facilities success in any regulatory survey. Participates on various committees and other task forces as may be established by management to plan, organize and drive the facility. Directs and participates in regular discussions and reviews on a variety of complex issues including financial and administrative matters, which have hospital-wide impact. Responsible for making decisions required to maintain acceptable operations based on strategic goals and policies. Displays ingenuity and foresight in determining the most appropriate solution in the absence of established guidelines. Confers with other department directors when necessary to resolve procedural difficulties, clarifying department responsibilities, objectives and resolving identified problems. Directs, reviews and analyzes progress and performance of contract services personnel. Makes recommendation on contract initiation, renewals and termination. Responsible for special projects as assigned and meets all objectives as set forth in individual evaluation and displays a good work attitude towards job responsibilities.