Director-Case Management

Case Management Director-RN oversees a staff of case management RNs, LPNs, Social Workers, and/or Case Management Assistants responsible for patient care coordination, discharge planning, utilization review, and social services. The director ensures alignment of objectives and initiative to support organizational goals. A Case Management Director-RN evaluates patient care data to ensure that care is provided in accordance with clinical guideline and organizational standards.

Responsibilities Oversees transition management and discharge planning to promote length of stay, care coordination, and patient flow. Ensures consistency in workflows, documentation, quality, and outcomes of the department. Participates and supports readmission reduction strategies.

Contributes to overall quality, patient satisfaction, and financial goals. Works with medical staff, nursing, administration, and other disciplines to improve care, reduce waste, increase efficiency, and achieve optimal outcomes. Supports revenue cycle activities supporting utilization review, medical necessity, payor requirements, and denial prevention.

Ensures compliance with state and federal regulatory requirements, TJC accreditation standards, and CMS requirements. Accountable for budgeting and financial performance of the department. Interviews, hires, trains, and supervises of all employees of the department.

Provides opportunity for professional growth through continued education and training. Performs other duties as assigned while supporting the mission, vision, and values to enhance quality, utilization, service delivery, and customer satisfaction. Specifications Experience Minimum Required 5 years acute care nursing; 2 years of case management Preferred/Desired Management experience Education Minimum Required Bachelors Degree as Registered Nurse Preferred/Desired Master’s degree as Registered Nurse Training Minimum Required Preferred/Desired Special Skills Minimum Required Preferred/Desired Licensure Minimum Required Current RN licenses in state which practicing Preferred/Desired