Case Management Director
: Job Details :

Supervise Case Managers and Social WorkersCollaborate on quality improvement and resource optimizationManage personnel actions and facilitate multidisciplinary care roundsThe Director of Case Management leads and oversees the hospital's case management program, ensuring effective care facilitation, utilization management, and discharge planning. This role is crucial in coordinating patient care, optimizing resource use, and maintaining compliance with regulatory standards.Supervision:Manages and supervises Case Managers and Social Workers.Key Responsibilities:Provide leadership, education, and day-to-day supervision of Case Managers and Social Workers, ensuring compliance with regulatory documentation standards.Collaborate with the CFO and Quality Department to develop and maintain quality improvement programs, focusing on metrics such as avoidable days and readmissions.Act as a liaison between physicians and case management teams to develop appropriate treatment plans and assist with patient care decisions, including level of care and bed placement.Manage all personnel actions, including hiring, performance evaluations, scheduling, and payroll.Lead daily Multidisciplinary Rounds to ensure holistic patient care through collaboration with other healthcare disciplines.Participate actively in discharge planning, providing education and resources to meet patients' and families' needs.Serve on the Utilization Review Committee and Revenue Cycle Committee, promoting efficient use of clinical resources.Ensure compliance with all applicable Joint Commission, CMS, state, and local regulations, as well as internal policies and professional standards.Knowledge, Skills, and Abilities:Expertise in payer requirements, discharge planning regulations, and the development of departmental policies.Strong understanding of Medicare, managed care, and the continuum of care, including inpatient, outpatient, and home health services.Ability to work collaboratively across all levels of healthcare to improve quality outcomes.Knowledge of performance improvement concepts.Self-motivated, with excellent communication skills and the ability to work both independently and as part of a team.Proven ability to build effective working relationships with physicians.Education:Graduate of an accredited Registered Nursing program.Bachelor of Science in Nursing (BSN) preferred.Experience:Minimum of two years of experience in case management, utilization management, discharge planning, or related areas.Two to three years of previous management experience, with at least two years in hospital-based nursing, is preferred.Certifications/Licenses:Iowa Mandatory Reporter – Child and Dependent Adult Abuse Certificates.Current RN license in the state of Iowa or a multistate license allowing practice in Iowa.#J-18808-Ljbffr