Durham, North Carolina
Des Moines, Iowa
Des Moines, Iowa
Los Angeles, California
Posted: 16-Dec-22
Location: Spartanburg, South Carolina
Type: Full Time
Salary: $125,000 - $165,000
Salary Details:
Required Education:
Position Summary
The Director of Case Management, under the guidance of the Finance Executive, serves as the primary administrator for Case management at the healthcare system acute care facilities and is responsible for the planning, development, organization, direction, and monitoring of the total program of Case Management. Accountable for developing and coordinating the mechanisms to assure compliance with the regulatory standards governing healthcare plans and patient care and is the contact for the state Quality Improvement Organization. Responsibility includes coordinating the Internal Physician Advisor program in conjunction with the Medical Director of Case Management. Works collaboratively across the system to drive system care transition initiatives.
Core Job Responsibilities
- Collaborate with departments across the healthcare system and the community to achieve excellent outcomes through continuous improvements to achieve and exceed national benchmark clinical quality initiatives for care management and transitions of care.
- Promote a culture of service to deliver exceptional customer service.
- Ensures hospital compliance with regulatory requirements of utilization review and discharge planning.
- Demonstrates strong knowledge of budget preparation and use. Operates with fiscal responsibility to provide the department’s Scope of Service in both the Operating and Capital budgets.
- Applies strategic planning to determine departmental objectives that support the organizational mission and goals.
- Ensures clinical competencies of associates to provide clinical excellence and meet quality goals.
- Creates, communicates, and implements a comprehensive and sustainable associate engagement strategy.
- Lead associates using a proactive approach for identifying and solving challenges.
- Delegates, plans, and implements procedures and systems to maximize efficiency.
- Manages operations of case management departments across the system.
- Manages the Physician Advisor program collaboratively with the Medical Director of Case Management.
- Participates in Joint operating committees and provides input to payor strategy related to the functions of case management within contracts.
- Supports revenue cycle initiatives such as denials management.
- Promotes community health initiatives.
- Demonstrates commitment to professional growth by attending or participation in management training and/or continuous education on an annual basis.
- Other duties as assigned
Minimum Requirements
Education
- Master’s Degree in Nursing. A Master’s degree in Business Administration or other healthcare related field will be considered if the nurse has earned a Bachelor of Science Degree in Nursing from an accredited education provider.
Experience
- Minimum of 10 years varied healthcare practice with diverse experience in case management and 5 years’ experience in supervisor or management position.
License/Registration/Certifications
- Current license with the South Carolina State Board of Nursing or Compact State.
