Director of Case Management

POSITION SUMMARY

Responsible for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patient, families and caregivers.    Completes established competencies for the position withindesignated introductory period.    Other related duties as assigned.
 

·    Establishes goals and objectives that support overall strategic plans of the facility/Baptist Health System
·    Develops and manages the annual department operating and capital budgets
·    Directs daily operations of assigned department/s
·    Directs performance of staff
·    Maintains objectivity in decision making, utilizing facts to support decisions
·    Supports the mission statement, policies and procedures of the Baptist Health System

·    Manages to eliminate boundaries to achieve integrated, efficient and quality service
·    Achieves ongoing compliance with all regulatory agencies
·    Serves as a resource to employees and customers as demonstrated by visibility and knowledge of issues
·    Demonstrates flexibility in response to change
·    Anticipates and responds to problems and risks
·    Communicates effectively with all levels in the organization and with inter/external customers

 

MINIMUM EDUCATION: Bachelor’s Degree from an accredited school, college or university as a Registered Nurse
PREFERRED EDUCATION: Master’s Degree from an accredited college or university in Nursing or related field
MINIMUM EXPERIENCE: 2 years in acute hospital case management, healthcare or leadership experiences
PREFERRED EXPERIENCE: 5 years in acute hospital case management. McKesson InterQual® experience and Business Planning experience
REQUIRED CERTIFICATIONS/LICENSURE: Possession of current Texas State registration as a Registered Nurse
PREFERRED CERTIFICATIONS/LICENSURE: Accredited Case Management (ACM)
REQUIRED COURSES/ COMPLETIONS (e.g., CPR): NA
 



Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Northeast Baptist Hospital hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.

At Northeast Baptist Hospital, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status