Director of Case Management, Case Management, 40 Hours, Monday- Friday, Day Shift (flexible hours), Sign On Bonus!

Overview

You Matter Here! Heywood Healthcare values our employees! We offer competitive wages, great benefits and generous earned time off.

Come work where you will matter! This job may be eligible for a $20,000 Sign On Bonus!

Hours : 40 Hours, Monday- Friday, Day Shift (flexible hours), Sign On Bonus!

Job Summary :

As a member of the Heywood Healthcare Family, The Director of Case Management is responsible for the provision of service for Case Management, Social Service and Utilization Management for Heywood Hospital and Athol Hospital.

The Director is responsible for the oversight and management of the Swing Bed Program at Athol Hospital, a critical access hospital.

The Director will provide leadership, direction, and support for discharge planning, social work, utilization review, and Swing bed coordination in pursuit of high-quality outcomes, cost effectiveness, accountability, and best practice.

The Director will work collaboratively with community and internal stakeholders.

Responsibilities

ESSENTIAL FUNCTIONS

• Lead and direct all case management and social services activities, ensuring patient care coordination and adherence to clinical protocols and regulatory standards.
• Reviews department clinical services and operations, and tracks case management and social services activity.
• Identifies areas for performance improvement by examining productivity and workload within each department.
• Directs, coaches, mentors and assesses staff in service delivery,
• Develops and implements Utilization Review based on internal data collection, data received from external agencies, physician, advisors and the medical director.
• Analyzes appropriateness of resource utilization and communicates findings.
• Maintains necessary levels of staff qualifications, competencies, staffing levels, regulatory compliance, individual development plans, continuing education and performance appraisal.
• Manages resource use and directs expense and revenue decisions.
• Monitors outcomes and staffing needs to adequately allocate personnel resources.
• Ensures department achieves goals and objectives by developing scope of service and policies / procedures, establishing / maintaining effective relationships with physicians / APPs, and collaborating with other disciplines.
• Assesses goals and utilizes data to effect corrective action.
• Ensures appropriateness of admissions and proper reimbursement.
• Works collaboratively with finance.
• Ensures proper discharge planning for a smooth transition post-acute care.
• Reviews and presents data relative to avoidable days, denials, length of stay and other key metrics to leadership.
• Perform internal audits to ensure compliance with organizational and state / federal practices, policies, and regulations.

Statement of Other Duties This document describes the major duties and responsibilities for this job, and is not intended to be a complete list of all tasks and functions.

It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described.

FUNCTIONAL DEMANDS Physical Requirements :

Exerts up to 20 pounds of force occasionally, and / or up to 10 pounds of force frequently, and / or a negligible amount of force constantly to move objects.

Frequently reaches (extending hands and arms in any direction), and handles (seizing, holding, grasping, turning, or working with hands).

Qualifications

Job Requirements

Minimum Education

BSN and / or MSN preferred.

Required Licenses / Certifications

Registered nurse required with an active Massachusetts license.

Required Skills

Five or more years of case management experience.

Previous management experience required.