Director of Case Management

Director Of Case Management

Job Location : Home Office - Oklahoma City, OK

Position Type : Full Time

Education Level : 2 Year Degree

Job Category : Case Management

Description

Job Purpose :

The Director of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and consultation to case managers, social workers and case management coordinators. 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.

Essential Functions Include But Not Limited To :

• Researches and identifies relevant industry standards. Updates job knowledge by studying trends and developments in case management.
• Collaborates with executive management, establishes benchmarks that are attainable but exceed industry standards.
• Introduce solutions to minimize denials, accommodate higher patient volumes and strengthen overall quality metrics.
• Enhances clinical and financial outcomes through performance improvement activities.
• Assists facility Case Management departments in regulatory compliance.
• Directs and evaluates all services provided, including care plan development, service level determination, and complaint management to achieve performance and quality control objectives.
• Provides specialized expertise, ensures resource alignment with system-wide initiatives, and updates appropriate parties on initiatives, outcomes and issues.
• Performs under minimal supervision with accountability for specific goals and objectives.
• Identifies and resolves problems.
• Demonstrates problem solving, leadership, conflict management and team building skills in order to ensure a productive work environment and achievement of goals.
• Enhances department and organization reputation by accepting ownership for accomplishing new and different requests; explores opportunities to add value to job accomplishments
• Oversees internal audits to ensure consistency and compliance with organizational standards, clinical pathways, and external requirements
• Evaluates clinical documentation with regard to medical necessity, appropriate use of clinical pathways, evidence-based care, and efficiency of care
• Ensures compliance in all risk management matters for Company's various lines of business, including all state, federal, and regulatory body requirements
• Other duties as assigned within scope of practice.

Behavioral Standards

Education / Qualifications :

Certification / Licensure :

Physical Requirements :