Director, Case Management

Job Summary

The Director of Care Management oversees the Care Management and Social Services departments. In this role, the Director establishes best practice programs to ensure effective and efficient coordination of patient care in accordance with clinical, organizational, and other applicable guidelines and standards. Seeks treatments that balance clinical and financial concerns with a family's needs and the patient's quality of life. Additionally, Director contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care. Establishes outstanding rapport and coordinates with physicians, clinicians, health plans, and local providers such as skilled nursing facilities, long-term care facilities, home health agencies, and ambulance companies.

Licensure and Certification:

• Current California RN License required

• Specialty certification(s) in the areas of Case Management and/or Administration is preferred

Education:

• Bachelor's in Nursing required

• Master's degree in related field preferred

Experience:

• A minimum of five (5) years progressive experience in a management or administrative capacity in hospital case management.

Knowledge and Skills:

• Knowledge of DRGs, Medicare Regulations, Medical Necessity Criteria, and associated knowledge specific to Case Management.

• State and Federal regulations, including Title 22 and all other regulatory requirements.

• Effective oral and written communication skills; budgeting principles and procedures; analytical skills and system analysis.

• Knowledge of supervisory theories, principles, practices, techniques and methods.

• Ability to manage staff and change through collaborative and positive leadership skills.

• Ability to work collaboratively with teams members, hospital staff, physicians and patients.

• Demonstrated ability in interpersonal relationships which enhances communication, promotes conflict resolution, and facilitates staff development.

• Skill and knowledge to sustain and evaluate clinical competence for the specific age and type of patient population served.

Physical Demands - Clerical/Administrative Patient Care:

• Frequent sitting and standing/walking with frequent position change.

• Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.

• Occasional/intermittent reaching at or above shoulder level.

• Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing.

• Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.

• Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.

Key for Physical Demands

Continuous

66 to 100% of the time

Frequent

33 to 65% of the time

Occasional

0 to 32% of the time