Director of Case Management
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POST DATE 8/20/2016
END DATE 11/6/2016
JOB DESCRIPTIONJob Code: 26750-199
* Demonstrates responsibility and accountability in ensuring case management process is initiated effectively across the organization, and patients receive the appropriate level of care across the continuum.
* Ensures provision of quality services by maintaining appropriate resources, staffing levels, competency of staff, maintenance/and performance of equipment, physical space, and training and education of staff.
* Ensures delivery of high quality services and contributes to continuity of care through demonstrated use of interdisciplinary team approach to patient care. Works collaboratively with internal and external resources and agencies, physicians and all members of the interdisciplinary team in meeting stakeholder needs and organizational goals.
* Coordinates assessment of appropriate utilization of services, ensuring intervention as needed. Analyzes utilization data, identifies patterns and trends, and ensures information flow to appropriate committees.
* Ensures patient case management plans are developed, implemented and evaluated in a timely manner in collaboration with attending physician.
* Shares pertinent patient information with physicians, and other members of the interdisciplinary team regarding patient progress, treatment, and discharge planning as appropriate.
* Applies the principles of continuous quality improvement in delivery of services through assessment, measuring, and monitoring of case management processes and systems.
* Ensures compliance with JCAHO and ensures all regulatory and accrediting agencies requirements are met.
* Demonstrates knowledge of the occurrence reporting system and reports trends in occurrences to staff quarterly. This information is used to improve patient safety. Addresses patient safety in the Performance Improvement Plan.
* Ensures staff is educated on established guidelines for reporting a significant medical error or unanticipated outcome in the patient's care which results in patient harm.
Bachelors Degree in Nursing or related field from an accredited college or university
Minimum three years in acute care discharge planning utilization monitoring, case management, third party payor review and contract compliance and CQI
Knowledge of payer requirements and discharge planning regulations. Aptitude with data.
Last Edited: 08/19/2016