Permanent - Administrative Director of Care Management ...

The Director of Care Management is responsible and accountable to work with the Directors of Case Management on the implementation of the case management program at the local level. The componentsroles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning.The Director is responsible for overseeingsuggesting the development of systems and processes for careutilization management at the local level. In addition, the Director is responsible for monitoring the progress of hospital department activities related to discharge planning and clinical quality improvement. The Director works with the local level Directors on matters that impact resource utilization and promotes the effective and appropriate use of hospital resources. The Director supports the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement. The Director promotes interdisciplinary collaboration, fosters teamwork and champions service excellence.Minimum Qualifications:Education: Bachelors of Nursing (BSN) or Masters Social Work (MSW). Masters degree preferredLicensesCertifications:Current and valid license to practice as a Registered Nurse in the state of Texas orCurrent and valid Texas license as a Master's Social Worker (LMSW) required,LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM) orFellowship of the American Academy of Case Management (FAACM) required .Experience Knowledge Skills:Minimum five (5) years' experience in utilization management, case management, discharge planning or other costquality management program.Three (3) years of experience in hospital-based nursing or social work preferred.Knowledge of leading practice in clinical care and payor requirements.Self-motivated, proven communication skills, assertive.Background in business planning, and targeted outcomes.Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management.Working knowledge of the concepts associated with Performance Improvement.Demonstrated effective working relationship with physicians.Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.Effective oral and written communication skills.RequirementsMinimum five (5) years' experience in utilization management, case management, discharge planning or other costquality management program.Three (3) years of experience in hospital-based nursing or social work preferred.Knowledge of leading practice in clinical care and payor requirements.Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management.

Created: 2025-02-27