Director of Case Management 9/2/2016

Cynet Systems Temecula, CA

Company
Cynet Systems
Job Classification
Full Time
Company Ref #
29511797
AJE Ref #
576077404
Location
Temecula, CA
Job Type
Regular

JOB DESCRIPTION

APPLY
We are looking for DIRECTOR OF CASE MANAGEMENT for our client in TEMECUAL, CA

JOB TITLE: DIRECTOR OF CASE MANAGEMENT

JOB LOCATION: TEMECUAL, CA

JOB TYPE: FULL TIME
JOB DESCRIPTION:

* Required Director of Case Management
* The establishment and maintenance of a comprehensive, effective Utilization Management Plan provides a framework for the judicious use of resources to control inappropriate admissions, lengths of a stay, use of ancillary services and appropriate settings in which services are provided.
* Care Coordination services ensure that planning for alternate level of care needs are addressed in a timely fashion, assisting the patient through the process of discharge and facilitating follow up care with a patient/family centered focus.

GOALS AND OBJECTIVES:

* Utilization Management provides for admission review, discharge planning coordination and support during the hospital stay using established criteria and standards of care.
* The goal of the Care Coordination Department is to facilitate the appropriate level of clinical services both during the hospital stay and post discharge and to coordinate a smooth transition for patients and families to the next level of care within the continuum.

THE CARE COORDINATION DEPARTMENT:

* The Director of Case Management shall have the appropriate educational background and utilizationexperience to direct, supervise and manage the Care Coordination activities throughout the institution.
* Works with Medical staff and departments to ensure coordination and integration of medical and clinical processes to ensure patient safety and regulatory compliance.
* They respond to situational opportunities and/or problems that occur in a timely manner and demonstrates ability to maximize opportunity or minimize the problem.
* Performance Improvement V Active member of Performance Improvement teams that contribute to organization planning, operations and regulatory compliance.
* Participates in ongoing performance improvement that promotes patient safety through reduced length of stay, standardization of care and attainment of key quality metrics.
* Facilitates development of policies and procedures that guide and support the provision of clinical services.
* Ensures timely implementation and ongoing compliance.
* Utilizes and incorporates IT into the employee workflow, patient flow and education, access to DME, prescriptions and extended care providers post discharge.

ESSENTIAL KNOWLEDGE / SKILLS:

* Demonstrates well developed problem solving, communication and interpersonal skills
* Effective written and verbal communication skills.
* Ability to define problems, collect data, establish facts and draw conclusions.
* Demonstrates knowledge of principles of utilization management and case management.
* Computer skills in word processing, excel, data analytics.
* Knowledge of regulatory compliance standards (CMS, Title 22, TJC)

MINIMUM ESSENTIAL EXPERIENCE:

* Five (5) years managerial experience in Utilization Review and/or Case Management
* Strong acute care clinical background.
* Three (3) years experience in a leadership role required.

MINIMUM ESSENTIAL EDUCATION:

* Completion of an accredited Registered Nurse Program
* Bachelordegree in nursing, health care management or other related field
* Master's Degree in healthcare related field preferred

REQUIRED LICENSURE / CERTIFICATIONS:

* Current California Registered Nurse License
* CPUR, CPUM, CCM or other national certification in Utilization Review or Case Management preferred.
* WORK ENVIRONMENT
* Ability to work in high volume fluctuating census environment