Director Case Management

Glenwood Regional Medical Center; West Monroe (LA); On-site; USD 90,000 - 130,000; Full time

Job summary

Glenwood Regional Medical Center is seeking a RN with Case Management leadership experience to oversee the Case Management Department. The role directs staff, budget, and resource utilization to optimize patient care and hospital performance.

You will coordinate multidisciplinary care planning, oversee utilization reviews, and drive discharge planning across the hospital. Strong supervisory skills and Louisiana RN licensure are required.

Qualifications

• Must be a graduate of an Accredited School of Nursing with a current Louisiana State Board license.
• RN Case Management experience in an acute care setting preferred.
• Previous supervisory experience preferred.
• Computer skills preferred.

Responsibilities

• Directs staff and fiscal resources of the Case Management Department and oversees the hospital Case Management program.
• Develops short- and long-term goals for cost containment, reduction of LOS, and utilization of hospital resources.
• Facilitates multidisciplinary care planning and coordination among physicians, pharmacists, nurses, social workers, and other health professionals.
• Directs utilization review activities with external payers to determine medical necessity of admissions and continued hospitalization.
• Resolves discharge planning conflicts and ensures smooth transitions for patients across the continuum of care.
• Establishes relationships with providers and community services to support patient transitions.
• Ensures compliance with applicable standards and participates in relevant task forces and external agency collaborations.
• Audits and monitors compliance; creates an environment encouraging staff to report and resolve issues.
• Performs other duties as assigned.

Skills

RN Case Management

Supervisory experience

Computer skills

Education

Registered Nurse (RN) degree

Job description

Position Summary

Responsible for the direction of staff and fiscal resources of the Case Management Dept. Oversight of the hospital Case Management program.

• Provides direction and planning for physician advisor, and staff to establish priorities identifying trends. Develop short- and long-term goals for cost containment and reduction of LOS and utilization of hospital resources.
• Provides direction and planning for physician advisor, and staff to establish priorities identifying trends. Develop short- and long-term goals for cost containment and reduction of LOS and utilization of hospital resources.
• Develops structures and processes to facilitate participation by physicians, pharmacists, nurses, Social Workers and other health professionals in multidisciplinary care planning, care delivery, and discharge planning.
• Directs utilization review activities for the hospital, interfacing with external payers and review companies to determine appropriate medical necessity of admissions and continued hospitalization.
• Resolves conflicts related to discharge planning with patients/families, external agenand payers.
• Facilitates transition of patients/families across the continuum by establishing relationships with appropriate providers and community services.
• Ensures compliance with DNV standards for the Continuity of Care function.
• Participates as a member of DNV Task Force.
• Establishes effective relationships with external agencies providing services to the organization (such as vendors, care providers, etc.).
• Effectively audits and monitors areas of responsibility for compliance issues. Promptly follows up on compliance issues. Creates an environment that encourages staff to report/resolve complicated issues.
• Employee is dependable and completes other assigned duties on schedule and these duties do not have to be redone.

Qualifications

• Must be a graduate of an Accredited School of Nursing with a current La State Board License.
• RN Case Management experience in an acute care setting preferred. Previous supervisory experience preferred.
• A current Louisiana license is required.
• Computer skills preferred.

Please indicate whether you have ever been convicted of a crime, including any misdemeanors and/or DUI/DWI. (Criminal conviction(s) will not automatically exclude you from consideration for employment).