Director Care Management

Hours of Work :

Mon-Fri

Days Of Week :

8A-5P

Work Shift :

Job Description :

Your Job:
Serves as Director of Care Management responsible for implementing and supervising the day-to-day operation of the Care Management and Utilization Management Programs of the Hospital. Manages activities necessary to ensure appropriate utilization of the Hospital and its resources while maintaining optimal achievable standards of patient care. Maintains the strictest confidentiality of all patient information.

Your Job Requirements:

•  Bachelor's degree in healthcare-related field required.
•  Master's degree in Nursing, Health Care Administration, Public Health, Business Administration, preferred.
• Registered nurse graduated from an accredited school of nursing with a state license to practice professional nursing.
• Working knowledge of Federal, State and regulatory requirements in quality assessment, case management, resource management, hospital systems, accreditation and licensure.
• Ability to extensively communicate with outside agencies, third party payers and regulators.
• Ability to lead, support and build on current efforts of various groups working within the department's scope of work.
• Five (5) years of relevant progressive work experience in clinical healthcare, including direct experience in quality assessment and resource management.
• Function independently under the guidance of VP within the broad scope of department and organization-wide policies, practices and common goals.
• Generally refers specific problems to VP only when the clarification of operating policies and procedures may be required.
• Possess good analytical and problem-solving skills. Ability to work with computerized clinical information systems. Initiative, flexibility, integrity and diplomacy.
• Prior management experience in hospital-wide quality resource management programs, monitoring and evaluation, experience in ensuring compliance with federal and state regulations and statutes relating to healthcare delivery.
• Strong professional organizational and interpersonal skills required for effective and creative leadership in working with all levels of the organization including physicians, committees, senior management and trustees, as well as patients and their families.

 Your Job Responsibilities:

• Assists in the assessment of anticipated impact of external regulations and cost-containment efforts related to Utilization Review, Case Management.
• Attains all agreed to goals and objectives within specified time frames as part of the overall mission.
• Attends all required Safety Training programs and can describe his or her responsibilities related to general safety, department/service safety and specific job-related hazards.
• Attends all required Safety Training programs and can describe his or her responsibilities related to general safety, department/service safety and specific job-related hazards.
• Collaborates with other departments to create systems and problem-solve ongoing issues that affect departmental/organizational goals and/or patient care delivery.
• Collects, analyzes, evaluates and monitors data to achieve program goals.
• Confidentiality of Hospital and Patient Information
• Defines performance objectives and metrics for the department and assesses the level of competence of staff in a timely manner.
• Demonstrates a clear understanding of regulations applicable to patient care and/or other department functions.
• Demonstrates a commitment to a healthy work environment by modeling the desired behaviors and encouraging those in others.
• Demonstrates fiscal accountability for department resources and the ability to achieve outcomes within allocated resources.
• Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment.
• Demonstrates the ability to communicate the hospital's mission, vision and values, as well as departmental goals, to all staff.
• Demonstrates the ability to cope with and manage change and to help others do the same.
• Effectively communicates departmental, organizational and industrial information to staff.
•  Follows the Hospital Exposure Control Plans/Blood borne and Airborne Pathogens.
•  Hospital Exposure Control Standards/Blood Bourne and Airborne Pathogens
•  Incorporates quality improvement data and/or patient satisfaction data into departmental goals.
• Initiates and coordinates special projects pertaining to Case Management.
• Manages Human Resource to ensure quality services and promote positive employee relations.
• Member of appropriate hospital committees, both medical STAFFnd operational.
• Oversees Case Management activities.
• Oversees