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Job description
Director of Case Management
Great Benefits – Medical, Vision, Dental, PTO & 401K
Individually Tailored 6-12 Week Orientation
Opportunities for Advancement
Career Ladder for RNs, LVNs, & CSTs
Consumer discounts through Perks
Family Atmosphere
Opportunity for Multi-Unit Training
Free CEUs through Cornerstone, our online training system
Responsibilities
Plans, directs, implements and monitors hospital-wide efforts to ensure appropriate level of care and psychosocial interventions while serving as a liaison for the hospital with medical staff, hospital departments and services, regulator and extra review agencies, third party payers, financial services and community health and welfare services.
Coordinates programs among departments and ensures services according to the appropriateness of care, appropriateness of admissions and continued hospitalizations, monitors length of stay, observation status utilization, delays in discharges or care, case mix index and other reimbursement/financial indicators in order to recommend and implement hospital-wide improvement strategies.
Performs concurrent reviews for patients to ensure that extended stays are medically justified and documented in patient’s medical records.
Refers to the Utilization Review Physician Advisor(s) all cases that do not meet established guidelines for admission or continued stay.
Assists in patient facilitation through participation in daily bed management meetings and implementation of multi-disciplinary activities to improve quality of care.
Participates in the development of effective hospital-wide Care Management strategies, ensuring compliance with external accrediting agencies and patient care review requirements.
Ensures compliance regarding resource allocation, discharge planning and social work intervention processes in accordance with regulatory agencies including but not limited to DOH, CMS, etc., and other authority, and acts as a liaison of the same.
Serves as a change agent for implementation of new programs and existing ones.
Works independently and provides and coordinates patient care using an interdisciplinary approach encompassing the entire continuum of care which may include outpatient, inpatient and post hospital services.
Helps to develop and utilizes medical guidelines in an effort to provide high quality, cost effective care sensitive to the resources available.
Utilizes data to make informed decisions related to the delivery and outcomes of Case Management, department productivity and staffing.
Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs.
Complies monthly reports and statistics to the Utilization Review Committee.
Integrates and coordinates services using continuous quality improvement tools.
Maintains a positive work environment for staff and physicians and promotes team efforts.
Adheres to established departmental operation and salary budgets, and provides explanations of budget variances.
Ensures performance evaluations are current and are reviewed by employees and completed timely.
Completes initial departmental orientation and competency review for newly hired employees.
Ensures that all licensure/credentials certificates for applicable personnel are valid and up to date. Updates and maintains job descriptions for each job classification in accordance with hospital policy and procedures.
Additional duties as assigned.
Qualifications
3 – 5 years’ experience in a hospital setting as a case manager with utilization review experience
Certification as a Case Manager preferred
Licensed as an RN in the state of Texas, BCLS.
BSN preferred
Prior supervisory experience preferred
Shift
Full Time
Incentives
Flexible Scheduling
No mandatory overtime
Lubbock#250
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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Worksite address
lubbock, TX, 79430, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.