Director Case Management RN
Company: The Clinical Recruiter
Posted on: June 15, 2022
(Only QUALIFIED Healthcare Professionals accepted) Case Manager
- Director Case Management RN
* Relocation Assistance *
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
Develops case management programs that allows the hospital(s) to
meet clinical resource management goals as well as third party and
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
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
Works effectively with MCO staff and leadership to decrease denials
or downgrades in reimbursement.
Maintains department standards for regulatory and accreditation
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
Recommends plans of care for high profile DRGs that incorporate
effective Case Management strategies.
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
Five years of recent management in acute care hospital case
management setting preferred
Bachelors of Science in Nursing or related field and Nursing Degree
from an Accredited Nursing School or Masters prepared Social Worker
Masters Nursing, Masters Health Administration or MBA preferred
Current Arizona Registered Nurse License or, MSW with State of
Arizona licensed Social Worker.
Accredited Case Manager (ACM) or Certified Case Manager (CCM)
Must successfully complete Midas, InterQual and Curaspan training
within 90 days
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
Keywords: The Clinical Recruiter, Goodyear , Director Case Management RN, Healthcare , Goodyear, Arizona
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