Registered Nurse (RN) Director Case Management
Reporting to the Chief Financial Officer, this individual provides operational management, overall leadership and strategic planning for the Case Management / Utilization Management department, including pre-admissions review, utilization review, social services, and discharge planning.
- Overseeing department/program evaluation.
- Prepare and monitor departmental budgets.
- Ensure appropriate utilization of resources, facilities and services by reviewing admissions, duration of stay, professional services rendered for both inpatients and observation patients.
- Develops and implements programs / activities to optimize patient length of stay, assures timely patient through-put and ensures appropriate discharge planning.
- Provides departmental needs assessment; identifies goals, develops and implements action plans in order to achieve objectives.
- Maintains current knowledge of governmental regulations, contractual issues and third party payor requirements – assures departmental compliance of same.
- Oversees provision of direct clinical social services to areas of the Hospital served.
- Identify patient discharge needs and work in collaboration with nurses and physicians in managing patient care need through the organization.
- Supervise staff.
Qualification / Requirements
- Bachelor’s degree required, Master’s preferred
- Current FL RN license
- ACM/CCM preferred
- 5+ years case management/utilization management and/or discharge planning experience in an acute hospital setting
- Knowledge of managed care and capitation
- 2+ years in a Director/Manager role over Case Management/Utilization Review strongly preferred