Case Management Director oversees a staff of case managers responsible for patient care coordination. Develops and implements case management programs, including utilization review, intake or discharge planning, and managed care contracting or negotiation. Being a Case Management Director evaluates patient care data to ensure that care is provided in accordance with clinical guidelines and organizational standards. Seeks treatments that balance clinical and financial concerns with the family's needs and the patient's quality of life. Additionally, Case Management Director contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care. Typically requires a bachelor's degree. Typically reports to top management. May require Registered Nurse (RN). The Case Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Case Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Education:
Required: Associates or Bachelor’s degree in nursing.
Experience:
Required: A minimum of two years professional experience in a clinically related area.
Preferred: Previous case management and third party payer interactions
Licenses/Certificates:
Required: Current RN licensure in the State of New Mexico
Required: Current BLS
Or
Required: Graduated with a Bachelor of Social Work (unless MSW required for licensing) from an accredited institution
Preferred: Masters of Social Work from an accredited institution
Required: Licensed Medical Social Worker (i.e. LSW, LCSW, ACSW, etc) in state of New Mexico within 6 months of employment
Preferred: ACM and/or CCM certifications
At Mountain View we pride ourselves on fostering an environment that is warm and welcoming where everyone feels heard, supported and valued. An environment that embodies a "family" culture that emphasizes not only the high standards in the care we deliver but also in the personal connections and relationships that form the heart of our institution. Our healthcare professionals and support staff work together as a close-knit family, united by a shared commitment to healing and improving the lives of our patients and each other.
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