Plans, organizes, coordinates, and directs the Utilization, Case Management, and Discharge Planning Programs. Monitors discharge planning services and counseling to patients and their families and consultation to medical staff regarding patient management.
Bachelor's degree in Nursing (BSN) required; Master's degree in Nursing (MSN), Healthcare Administration, Business Administration or related field preferred.
3 years healthcare management experience.
Registered Nurse (RN) in the State of Maryland.
Knowledge, Skills & Abilities:
Excellent problem-solving skills and ability to exercise independent judgment. Business acumen and leadership skills. Strong verbal and written communication skills with ability to effectively interact with all levels of management, internal departments and external agencies. Working knowledge of various computer software applications preferred.
Primary Duties and Responsibilities
Develops and contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Ensures compliance with hospital/facility policies and procedures and governmental/accreditation regulations.
Develops and recommends department operating budget and manages resources according to approved budget.
Selects, trains, orients, and assigns department staff. Delegates tasks as appropriate. Develops standards of performance, evaluates performance, and conducts performance management planning. Identifies individual staff development needs and provides appropriate resources to meet needs. Initiates or makes recommendations for personnel actions. Maintains ongoing communication with subordinates to review programs, provide feedback, discuss new developments, and exchange information.
Contributes to the development, review, revision and implementation of clinical pathways, procedures and guidelines at the hospital and system level.
Coordinates the facilitation of patient transition from area to area in a timely, cost effective manner. Assures that the hospital-based program encompasses preadmission, emergency room, admitting, acute care, discharge follow-up, sub-acute and rehabilitation.
Directs and participates in the provision of social services in the areas of psychosocial assessment and counseling, crisis intervention, child abuse, home health care, oncology, and other support groups' discharge planning.
Ensures the delivery of quality care to inpatients and outpatients by identifying patient needs and developing social service programs to meet those needs.
Monitors and evaluates the effectiveness of policies and practices with regard to length of stay and utilization of resources.
Oversees monthly monitoring and reporting of critical data on LOS, discharges, clinical and teaching outcomes, denials, overturned denials, and other reports.
Provides direction and support regarding Utilization Management, Case Management, Discharge Planning, and Social Work.
Serves as the hospital liaison to payers in matters pertaining to utilization of acute care services. Makes recommendations regarding third party case management contracts.
Participates in meetings and on committees and represents the department and business unit in community outreach efforts. Participates in multidisciplinary quality and service improvement teams and maintains effective working relationships with other departments.
Performs other duties as assigned.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.