Director, Case Management

AHS Vista LLC

  • Waukegan, IL
  • Permanent
  • Full-time
  • 1 month ago
  • Apply easily
The Director of Case Management is responsible for the development, planning, coordination and administration of the activities of Utilization Review and Resource Management; responsibilities include facility wide direction of quality and cost-efficient patient care. The CMD will be responsible for administrative duties as well as all duties associated with a floor Case Manager.Responsibilities:
  • Ensures that the Case Management organization complies with all healthcare regulations, nursing regulations, Joint Commission, & co. policies & procedures.
  • Identifies ideas, actions, & processes to improve quality, reduce risk, & maintain patient safety.
  • Maintains knowledge of healthcare delivery models, healthcare economics, and healthcare policy.
  • Acts as a liaison with the nursing/ medical staff, patient, families and community agencies to facilitate problem solving, post discharge care and coordination of services.
  • Develop reporting tools that effectively measure and monitor processes throughout the denials management process in order to support process improvement.
  • Ensures the department financial budget is achieved.
  • Effectively utilizes database management, decision support, and expert system programs to access information and analyze data from disparate sources for use in planning for Case Management processes and systems.
Requirements:
  • Must possess Bachelor's in Nursing (BSN) degree, Masters in Nursing, Health Care or Business Administration, preferred.
  • Five to seven years' experience in Case Management, discharge planning, and/or utilization review.
  • Minimum of five years clinical Nursing in an acute care setting.
  • Knowledge of regulatory and payer requirements for reimbursement and reasons for denials by auditors.

AHS Vista LLC