DIRECTOR, CASE MANAGEMENT
LOCATION, Los Angeles, CA
Facility: Physician-owned heart hospital
The Director of Case Management is a working case manager who is responsible for the development of staff and systems to effectively operate a comprehensive Case Management/Utilization Review plan.
Provides leadership and supervision to case managers, clinical documentation specialists, social worker(s) and case management admininistration.
- Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs.
- Integrates and coordinates services using continuous quality improvement tools.
- Manages the utilization of resources and discharge process of all inpatients. Maintains continuity and coordination of all the various disciplines involved throughout the patient’s continuum of care including readmission.
- Provides education to staff/physicians/patients/families related to implementation of case management initiatives.
- Provides leadership for the Utilization Review Committee and processes, including active collaboration with the CM/UR Physician Advisor.
- Provides expertise and oversight in complex patient appeals and denials. Maintains and enhances relationships with referral and payor sources and assures quality care/outcomes while complying with various third party guidelines.
EDUCATION AND EXPERIENCE:
CONTACT: Michael Zimmer, Director
Finance, Administration and Nursing Executive Search
The Hutton Group, Inc.
- Graduation from a program of nursing required. BSN preferred.
- Current CA Registered Nurse license or licensure from a state within the Nursing Compact.
- Minimum of three (3) years clinical experience. Cardiovascular nursing experience preferred.
- Two years of case management experience preferred.