Director, Case Management - Career Growth Potential

Job Title: Director of Case Management, CM

Job Summary: The Director of Case Management assists the Regional/Market Director with the overall development of the case management program and implements at the local level. This includes oversight of all case management staff, development and implementation of case management policies and procedures, and coordination of care with other healthcare providers and community resources. The Director of Case Management also plays a key role in ensuring that the case management program is meeting its goals and objectives, and that it is compliant with all applicable regulations. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Essential Functions:

• Assists in the development and implementation of case management program, in alignment with its overall
  strategic goals and objectives.
• Oversee a staff of case managers, including hiring, training, performance management, and disciplinary action. Ensuring optimal provision of services through sound personnel management.
• Assist Regional/Market director with the development and implement case management policies and procedures, ensuring that they are aligned with best practices and applicable regulations.
• Coordinate care with other healthcare providers and community resources to ensure that patients receive seamless and comprehensive care.
• Provides comprehensive reporting to CEO and other stakeholders to include KPI’s, avoidable delays, LOS and other metrics as determined routinely.
• Monitor and evaluate the effectiveness of the case management program and adjust as needed.
• Ensure that the case management program is compliant with all applicable regulations.
• Maintain department performance improvement and quality plans.
• Represent the case management program to the organization's leadership team and to external stakeholders.
• Maintain current competencies and updated knowledge in the specific area of practice.
• Effectively manage financial resources within the area(s) of responsibility, including labor management, productivity, supplies, and other resources.
• Collaborate with UM physician chair to develop and participate in scheduled UM Committees
• Uses clear, concise, professional communication with coworkers, patients, all customers internal and external.
• Uses AIDET in interactions with patients and family members.
• Acts with a sense of urgency when performing tasks.
• Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter. Reports on any equipment and or environmental issues for repair.
• Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.
• Speaks up to stop the line and escalates potential safety events if necessary.
• Completes and attends monthly training assigned.
• Demonstrate behaviors commensurate with the vision, mission, values, and behavioral standards of the organization.
• Serve as a role model for the mission, vision, and values of the organization and fulfill other job duties as requested within the scope of practice.
• Serve as a role model and mentor for staff and peers.
• Treats everyone as their customer; utilizes scripting and other tools to ensure consistency in customer service; Expresses recognition and shows appreciation to others; fully utilizes AIDET principles; responds quickly to handle requests, complaints, and questions; displays a positive attitude.
• Demonstrates the highest level of professionalism, passion and care when interacting with patients, families, physicians, and hospital staff members.
• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential, embracing ingenuity to service our customers.

Experience:

• Minimum of five (5) years’ experience in Clinical Nursing required.
• Minimum of five (5) years’ experience in case management, preferably in a hospital setting.
• Minimum of three (3) years’ experience in a supervisory capacity or higher required.
• Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, strong organizational skills, ability to follow verbal instructions, and PC (computer) skills.
• A capacity to learn, synthesize, make critical judgments, work independently, place patients and families first, and collaborate with the team members who are recognized leaders within health care.

Licensure/Certifications:

• Current professional RN license issued and/or recognized by the state Board of Nursing for the State of employment.
• Basic Life Support (BLS) from American Heart Association (AHA) required.
• Certified Case Manager (CCM) or Accredited Case Manager (ACM) credential, preferred.

Education:

• Minimum bachelor's degree in healthcare related field, BSN preferred