Director, Case Management

Cullman Regional Medical Center Inc; Alabama; On-site; USD 85,000 - 110,000; Full time

Job summary

Cullman Regional Medical Center Inc is seeking a Case Management Leader to coordinate with physicians, nurses, social workers and the health team to expedite clinically appropriate, cost-effective care and smooth transitions of care.

The role involves overseeing precertification, payor authorization, and collaborative care management, applying process-improvement methods to evaluate outcomes and ensure adherence to quality guidelines. Strong leadership and communication are essential.

Qualifications

• Associate's degree in nursing or higher required.
• Current Alabama license to practice nursing.
• Five years of clinical experience in acute care.
• Hospital case management experience required.
• Management experience preferred.

Responsibilities

• Coordinate with physicians, nurses, social workers and other health team members to expedite appropriate care.
• Facilitate precertification and payor authorization processes.
• Lead and participate in case management activities and MDRs meetings.
• Assign duties, escalate issues and monitor workload for department efficiency.
• Promote patient safety, quality and evidence-based practice across the continuum.

Skills

Advanced communication

Interpersonal skills

Organizational skills

Prioritization

Microsoft Word

Excel

Team leadership

Education

Associate's degree in nursing

BSN preferred

Tools

Microsoft Word

Excel

Job description

Job Summary:Coordinate with physicians, nurses, social workers and other health team members to expedite medically appropriate, cost effective care and appropriate transitions of care.Facilitate precertification and payor authorization processes; facilitate collaborative management of patient care across the continuum; intervene as necessary.Promote effective utilization and assume a leadershipApply process improvement methodologies in evaluating outcomes of care.Maintain and ensure adherence to clinical guidelines, tools, and protocols based on evidence quality-based medicine related to quality measure indicators.Assist with and assume duties necessary for the case management department to function proficiently in absence of director. This includes but not limited to MDRs meeting attendance, assignment of duties, and escalation of issues.Account for designated work load.Demonstrate and encourage team behavior and exceptional patient/guest experiences.Uphold and promote patient safety and quality.Education:Associate's degree in nursing or higher degree is required. Currently licensed by the state of Alabama. BSN preferred.Experience:Five years' clinical experience in acute care setting i.e., medical surgery critical care, ER, OR required. Hospital case management experience required. Management experience preferred.Additional Skills/Abilities:Skill and proficiency in applying highly technical principles, concepts and techniques that are central to case management. Advanced communication and interpersonal skills with all levels of internal and external customers. Must be proficient in Microsoft Word and Excel. Excellent organizational skills are required. Must be able to set priorities appropriately and handle multiple issues concurrently.