Director of Case Management Location: Jackson West Medical Center, Miami, FL
Summary: Direct the day-to-day operations of the case management area, including inpatient, outpatient, mental health, and revenue cycle management.
Responsibilities:
- Lead managed care operations for Jackson Health System.
- Direct Case Management, Utilization Management, Disease Management, and Renal Management Programs.
- Develop and manage various Disease Management Programs (Diabetes, CHF, Hypertension, Asthma, AIDS DMI Project).
- Oversee the concurrent review process for PSN patients and prospective payment systems.
- Co-direct countywide Medical Management Program during disasters.
- Manage the Medical Foster Care Case Management Program.
- Adhere to compliance standards and support the commitment to ethical business practices.
- Perform all other related job duties as assigned.
Experience:
- 7 to 10 years of related experience; management experience is required.
Education:
- Bachelor's degree in a related field required; Master's degree strongly preferred.
Skills:
- Ability to analyze, organize, and prioritize work.
- Effective communication in both oral and written forms.
- Critical thinking and professional composure under stress.
- Sound and independent judgment.
- Knowledge of business and management principles.
- Monitoring and assessing performance for improvements.
Credentials:
- Valid Florida RN license required; Case Management certification preferred.
Working Conditions:
- Sedentary job function with occasional standing or walking.
- Frequent interaction with a diverse population.
- Possible exposure to communicable diseases and other hospital conditions.
- Personal Protective Equipment (PPE) may be required.