Veracity
Case Management Director - Ottumwa, IA 52501
SUPERVISES - Case Managers and Social Workers
Must-Haves
Graduate of a program of Registered Nursing.
Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program.
Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa
The Director of Case Management's primary responsibilities include: The manager of case management is responsible and accountable for the implementation of the case management program at the hospital level. The components/roles of the inpatient case management program consist of the following: care facilitation, utilization management, case management and discharge planning.
DUTIES INCLUDE BUT ARE NOT LIMITED TO • Provide leadership, education and supervision for the day to day workflow of Case Managers and Social Workers. • Monitor Case Management Department's documentation to ensure meets regulatory compliance. • Collaborate with Chief Financial Officer and Quality Department to develop and maintain quality improvement programs and trending of data (e.g. Avoidable Days , Readmissions) . • Maintain skills in case management and utilization review to allow for coverage of patient caseload to cover staffing needs of all areas of hospital. • Communicate with physicians concerning patient needs and aid with development of appropriate plan of treatment and assist with level of care and bed placement assignments . • Directly responsible for personnel actions including hiring, performance appraisals ,employee schedules, and maintain payroll records and time reports in KRONOS. • Facilitate daily Multidisciplinary Rounds to provide collaboration with other disciplines to provide holistic patient care. • Participate in discharge planning. Provides necessary education and resources to meet the discharge needs of individual patients and families. • Active participant of Utilization Review Committee and Revenue Recycle Committee. • Promote efficient utilization of clinical resources. • Promotes the appropriate amount of resources are used based on patient acuity. • Assures appropriate level of understanding, awareness and compliance with all applicable Joint Commission, CMS, state and local agency laws, internal/external regulations, guidelines, policies, procedures and professional standards. • Other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES • Working knowledge of payer requirements and discharge planning regulations that support the effect for the development of departmental policies, procedures and standards . • Working knowledge of Medicare, managed care, inpatient, outpatient and home health continuum, as well as utilization management , discharge planning and case management . • Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes. • Working knowledge of concepts of associated with performance improvement. • Self-motivated, proven communication skills, assertive, able to work independently and as a team member. • Demonstrated effective working relationships with physicians.
EDUCATION • Graduate of a program of Registered Nursing. • Bachelor of Science in Nursing degree preferred.
EXPERIENCE • Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program. • Two to three years previous management experience is preferred with minimum of two years' experience in hospital- based nursing.
CERTIFICATE/LICENSE • Iowa Mandatory Reporter - Child and Dependent Adult Abuse Certificates • Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa
SUPERVISES - Case Managers and Social Workers
Must-Haves
Graduate of a program of Registered Nursing.
Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program.
Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa
The Director of Case Management's primary responsibilities include: The manager of case management is responsible and accountable for the implementation of the case management program at the hospital level. The components/roles of the inpatient case management program consist of the following: care facilitation, utilization management, case management and discharge planning.
DUTIES INCLUDE BUT ARE NOT LIMITED TO • Provide leadership, education and supervision for the day to day workflow of Case Managers and Social Workers. • Monitor Case Management Department's documentation to ensure meets regulatory compliance. • Collaborate with Chief Financial Officer and Quality Department to develop and maintain quality improvement programs and trending of data (e.g. Avoidable Days , Readmissions) . • Maintain skills in case management and utilization review to allow for coverage of patient caseload to cover staffing needs of all areas of hospital. • Communicate with physicians concerning patient needs and aid with development of appropriate plan of treatment and assist with level of care and bed placement assignments . • Directly responsible for personnel actions including hiring, performance appraisals ,employee schedules, and maintain payroll records and time reports in KRONOS. • Facilitate daily Multidisciplinary Rounds to provide collaboration with other disciplines to provide holistic patient care. • Participate in discharge planning. Provides necessary education and resources to meet the discharge needs of individual patients and families. • Active participant of Utilization Review Committee and Revenue Recycle Committee. • Promote efficient utilization of clinical resources. • Promotes the appropriate amount of resources are used based on patient acuity. • Assures appropriate level of understanding, awareness and compliance with all applicable Joint Commission, CMS, state and local agency laws, internal/external regulations, guidelines, policies, procedures and professional standards. • Other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES • Working knowledge of payer requirements and discharge planning regulations that support the effect for the development of departmental policies, procedures and standards . • Working knowledge of Medicare, managed care, inpatient, outpatient and home health continuum, as well as utilization management , discharge planning and case management . • Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes. • Working knowledge of concepts of associated with performance improvement. • Self-motivated, proven communication skills, assertive, able to work independently and as a team member. • Demonstrated effective working relationships with physicians.
EDUCATION • Graduate of a program of Registered Nursing. • Bachelor of Science in Nursing degree preferred.
EXPERIENCE • Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program. • Two to three years previous management experience is preferred with minimum of two years' experience in hospital- based nursing.
CERTIFICATE/LICENSE • Iowa Mandatory Reporter - Child and Dependent Adult Abuse Certificates • Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa