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)
Bargaining Unit: Non Represented - Manager
Rate of Pay: $149,032 annually DOE
Summary
Ensures quality patient care is provided in a cost efficient manner, inclusive of tracking resource utilization and decreasing unnecessary hospital stays. The position is accountable for providing concurrent and retro reviews of the patient medical records using current guidelines. Responsible for overseeing daily operations/functions of Case Management Department.
Essential Duties and Responsibilities
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Supervisory Responsibilities
Carries out supervisory responsibility in accordance with the organization’s policies and applicable laws. Responsibilities include interviewing, hiring, training, assigning, coaching, counseling, and disciplining employees; administering scheduling systems; communicating job expectations; planning, monitoring, appraising, and reviewing job contributions; enforcing policies and procedures.
Minimum Education/Experience
Bachelor's Degree from college or vocational school from a National League of Nursing (NLN), Commission on Collegiate Nursing Education (CCNE) or equivalent accredited school of nursing. The nurse shall have completed a nursing education program that included clinical experiences with actual patients under the supervision of qualified faculty.
2-3 years relevant experience
Required Licenses/Certifications
California Registered Nurse (RN) - Upon hire
Nevada Registered Nurse (RN) - Upon hire
BLS: Employee will be enrolled in the Resuscitation Quality Improvement (RQI) Basic Life Support (BLS) Entry or Prep Curriculum (depending on their
previous BLS certification). - Within 3 months of hire into job
Other Experience/Qualifications
Required:
0 Case Management Director jobs found in Reno, NV area