Director of Case Management

Lubbock Heart & Surgical Hospital; Lubbock (TX); On-site; USD 120,000 - 160,000; Full time

Benefits offered by this job

Great benefits

6-12 week orientation

Career ladder for staff

Free CEUs

Job summary

Lubbock Heart & Surgical Hospital is seeking a Director of Case Management to lead hospital-wide care management initiatives and ensure regulatory compliance. This full-time role oversees interdisciplinary coordination, bed management meetings, and program development to optimize patient care and discharge planning across inpatient and post-acute services.

The position requires an RN licensed in Texas with utilization review experience and may prefer a BSN, along with prior supervisory

Qualifications

• 3–5 years’ experience in a hospital setting as a case manager with utilization review experience
• Certification as a Case Manager preferred
• Licensed as an RN in the state of Texas, BCLS.
• BSN preferred
• Prior supervisory experience preferred

Responsibilities

• Plans, directs, implements and monitors hospital-wide care management efforts; liaison for medical staff and departments.
• Coordinates programs among departments to ensure appropriate care, admissions and continued hospitalizations; monitor length of stay and financial indicators.
• Performs concurrent reviews to ensure extended stays are medically justified and documented.
• Assists in bed management meetings and multi-disciplinary activities to improve quality of care.
• Develops hospital-wide Care Management strategies; ensures compliance with external accrediting agencies and review requirements.
• Ensures resource allocation, discharge planning and social work processes in line with regulatory agencies.
• Acts as a change agent for new programs and existing ones.
• Works with interdisciplinary teams across inpatient, outpatient and post-hospital services.
• Uses data to inform decisions on care delivery, outcomes and staffing.

Skills

RN licensed TX

Utilization review

Supervisory experience

Education

Certification as a Case Manager

BSN preferred

Job description

Director of Case Management

• Great Benefits – Medical, Vision, Dental, PTO & 401K
• Individually Tailored 6-12 Week Orientation
• Opportunities for Advancement
• Career Ladder for RNs, LVNs, & CSTs
• Consumer discounts through Perks
• Family Atmosphere
• Opportunity for Multi-Unit Training
• Free CEUs through Cornerstone, our online training system

Responsibilities

• Plans, directs, implements and monitors hospital-wide efforts to ensure appropriate level of care and psychosocial interventions while serving as a liaison for the hospital with medical staff, hospital departments and services, regulator and extra review agencies, third party payers, financial services and community health and welfare services.
• Coordinates programs among departments and ensures services according to the appropriateness of care, appropriateness of admissions and continued hospitalizations, monitors length of stay, observation status utilization, delays in discharges or care, case mix index and other reimbursement/financial indicators in order to recommend and implement hospital-wide improvement strategies.
• Performs concurrent reviews for patients to ensure that extended stays are medically justified and documented in patient’s medical records.
• Refers to the Utilization Review Physician Advisor(s) all cases that do not meet established guidelines for admission or continued stay.
• Assists in patient facilitation through participation in daily bed management meetings and implementation of multi-disciplinary activities to improve quality of care.
• Participates in the development of effective hospital-wide Care Management strategies, ensuring compliance with external accrediting agencies and patient care review requirements.
• Ensures compliance regarding resource allocation, discharge planning and social work intervention processes in accordance with regulatory agencies including but not limited to DOH, CMS, etc., and other authority, and acts as a liaison of the same.
• Serves as a change agent for implementation of new programs and existing ones.
• Works independently and provides and coordinates patient care using an interdisciplinary approach encompassing the entire continuum of care which may include outpatient, inpatient and post hospital services.
• Helps to develop and utilizes medical guidelines in an effort to provide high quality, cost effective care sensitive to the resources available.
• Utilizes data to make informed decisions related to the delivery and outcomes of Case Management, department productivity and staffing.
• Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs.
• Complies monthly reports and statistics to the Utilization Review Committee.
  Integrates and coordinates services using continuous quality improvement tools.
• Maintains a positive work environment for staff and physicians and promotes team efforts.
• Adheres to established departmental operation and salary budgets, and provides explanations of budget variances.
• Ensures performance evaluations are current and are reviewed by employees and completed timely.
• Completes initial departmental orientation and competency review for newly hired employees.
• Ensures that all licensure/credentials certificates for applicable personnel are valid and up to date. Updates and maintains job descriptions for each job classification in accordance with hospital policy and procedures.
  Additional duties as assigned.

Qualifications

• 3 – 5 years’ experience in a hospital setting as a case manager with utilization review experience
• Certification as a Case Manager preferred
• Licensed as an RN in the state of Texas, BCLS.
• BSN preferred
• Prior supervisory experience preferred

Shift

Full Time

Incentives

• Flexible Scheduling
• No mandatory overtime

Lubbock#250

Equal Opportunity Employer
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