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Job description
The Director of Care Management is responsible and accountable to work with the Directors of Case Management on the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning.
The Director is responsible for overseeing/suggesting the development of systems and processes for care/utilization management at the local level. In addition, the Director is responsible for monitoring the progress of hospital department activities related to discharge planning and clinical quality improvement. The Director works with the local level Directors on matters that impact resource utilization and promotes the effective and appropriate use of hospital resources. The Director supports the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement. The Director promotes interdisciplinary collaboration, fosters teamwork and champions service excellence.
Minimum Qualifications:
Education : Bachelors of Nursing (BSN) or Masters Social Work (MSW). Masters degree preferred
Licenses/Certifications:
Current and valid license to practice as a Registered Nurse in the state of Texas or
Current and valid Texas license as a Master's Social Worker (LMSW) required,
LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM) or
Fellowship of the American Academy of Case Management (FAACM) required .
Experience/ Knowledge/ Skills: Minimum five (5) years' experience in utilization management, case management, discharge planning or other cost/quality management program.
Three (3) years of experience in hospital-based nursing or social work preferred.
Knowledge of leading practice in clinical care and payor requirements.
Self-motivated, proven communication skills, assertive.
Background in business planning, and targeted outcomes.
Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management.
Working knowledge of the concepts associated with Performance Improvement.
Demonstrated effective working relationship with physicians.
Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
Effective oral and written communication skills.
Requirements Minimum five (5) years' experience in utilization management, case management, discharge planning or other cost/quality management program.
Three (3) years of experience in hospital-based nursing or social work preferred.
Knowledge of leading practice in clinical care and payor requirements.
Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management.
Worksite address
houston, TX, 77246, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.