Director Case Management RN

Company: The Clinical Recruiter
Location: Goodyear
Posted on: June 15, 2022

Job Description:

(Only QUALIFIED Healthcare Professionals accepted) Case Manager - Director Case Management RN
Goodyear, Arizona
JO# 32181

* Relocation Assistance *

General Summary:
The Director of Case Management leads and manages the day-to-day operations of utilization, clinical resource and case management departments and focuses on the continuum of care for the patient population.
Develops case management programs that allows the hospital(s) to meet clinical resource management goals as well as third party and regulatory standards.
Manges and educates staff at all levels about effective clinical resource management. Provides formal and informal programs.
Maintains effective working relationships and effectively communicates the goals and objectives of the program to the medical staff, department staff, and others within and outside the hospital.
Evaluates the effectiveness of existing clinical protocols and pathways and makes recommendations for new ones.
Promotes organizational mission statement and goals and empowers staff and peers to achieve outstanding performance.
Effectively reports departmental activities, goals, and measures of success.
Works effectively with MCO staff and leadership to decrease denials or downgrades in reimbursement.
Maintains department standards for regulatory and accreditation purposes.
Actively seeks to resolve those issues brought forward by medical staff that have an adverse effect on patient outcomes.
Analyzes the issues for cost-benefit in terms of improving clinical and financial outcomes.
Prioritizes and recommends effective approaches that will improve clinical and financial outcomes in the hospital.
Primary liaison between Case Management and the hospital Quality Committee.
Recommends plans of care for high profile DRGs that incorporate effective Case Management strategies.

Experience:
Three years of acute care hospital case management, discharge planning and utilization management experience at a Director level with five years of acute care hospital case management experience required
Five years of recent management in acute care hospital case management setting preferred

Education:
Bachelors of Science in Nursing or related field and Nursing Degree from an Accredited Nursing School or Masters prepared Social Worker required
Masters Nursing, Masters Health Administration or MBA preferred

Certifications-Licensures:
Current Arizona Registered Nurse License or, MSW with State of Arizona licensed Social Worker.
Accredited Case Manager (ACM) or Certified Case Manager (CCM) required
Must successfully complete Midas, InterQual and Curaspan training within 90 days

Special Skills:
Advanced communication and interpersonal skills
Analytical and quantitative analysis skills
Ability to lead a complex department to reach and exceed goals
Ability to work with other departments
Knowledge of Managed care trends, Medicare and Medicaid regulations

Keywords: The Clinical Recruiter, Goodyear , Director Case Management RN, Healthcare , Goodyear, Arizona