The Director of Case Management is responsible for: Providing overall leadership and strategic planning for the Case Management and Social Services departments; Providing and/or overseeing department / program evaluation, development of goals, creation and implementation of action plans; Communicating the direction, vision and values of the Organization.

Supervise: Supervisor and staff of Case Management/Social Workers Department
 

Position Duties & Responsibilities

1. Prepares and monitors departmental budgets
2. Oversees/provides for staffing plans / schedules; compliance with productivity targets
3. Provide for timely staff evaluations
4. In conjunction with organizational strategic plans, identifies opportunities for departmental improvements and implements appropriate action plans to optimize department outcomes.
5. Provides departmental needs assessment; identifies goals, develops and implements action plans in order to achieve objectives
6. Develops and implements programs / activities to optimize patient length of stay, assures timely patient through-put and ensures appropriate discharge planning
7. Oversees provision of direct clinical social services to areas of the Hospital served
8. Facilitates problem solving with other departments as indicated
9. Maintains current knowledge of governmental regulations, contractual issues and third party payor requirements - assures departmental compliance of same
10. As indicated, provides staff, physician and community education related to above regulations / requirements
11. Develops, revises and maintains departmental policies and procedures as indicated
12. Promotes and maintains positive relations with continuum of care providers
13. Provides outcomes reports as requested / required for Hospital and Medical Staff committees
14. Performs other duties as assigned

Required Knowledge Abilities and Licensing:

o Bachelors degree; Masters degree preferred
o Current Texas RN license
o Previous management experience
o Five (5) years experience with utilization management and discharge planning
o Knowledge of / experience with performance improvement activity
o Knowledge of state and federal regulations governing health plans - with extensive knowledge of Medicare/Medicaid 
o Knowledge of managed care and capitation

Desirable Qualifications Guide:

Minimum of 5 years of director level management experience in an acute hospital case management department (UR/DP). Strong interpersonal skills that reflect a positive attitude and sense of commitment to patients, the hospital, the departments and the community.