Director of Case Management

Prime Healthcare; Reno (NV); On-site; USD 100,000 - 140,000; Full time

Job summary

Saint Mary's Health Network in Reno, NV, seeks a Director of Case Management to lead a team of case managers, social workers and discharge planners. You will oversee staff development, program operations and utilization review to support high-quality patient care.

The role emphasizes data-driven planning, collaboration with clinical and ancillary services, and adherence to regulatory standards. 5+ years in case management and licensed social work status are required; CCM preferred.

Qualifications

• Licensed clinician status in your state is required.
• Minimum 5 years' post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
• Minimum 5 years' experience in a Case Management position.
• Must have analytical ability for problem identification and assessment and evaluation of data/statistics from ongoing review.
• Experience and knowledge in basic to intermediate computer skills.

Responsibilities

• Develops staff and systems to operate a comprehensive Case Management Program.
• Provides leadership and supervision to case managers, social workers and coordinators.
• Assesses needs and plans services aligned with hospital mission and patient/family needs.
• Coordinates services using continuous quality improvement tools.

Skills

Analytical ability

Computer skills

Education

Licensed clinician status in your state

Post graduate experience 5+ years in social work (LCSW)

BS/BSN preferred

Tools

Milliman Criteria

InterQual Criteria

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Saint Mary's Health Network, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

As a long-standing community partner with a 116-year history, Saint Mary's Health Network offers Northern Nevada inpatient, outpatient, ancillary, and wellness services. Nationally recognized and accredited by the Joint Commission, as well as named one of the Top 100 Hospitals by Fortune/Merative and America's Best 250 hospitals by Healthgrades, Saint Mary's Regional Medical Center is a 352-bed acute care hospital offering a robust line of inpatient, outpatient and ancillary services including a top-rated Center for Cancer, surgical and orthopedic services, and an award-winning Cardiology program and more. The health system, a member of Prime Healthcare, also operates a fully-integrated Medical Group, multiple urgent care clinics, freestanding imaging, lab, and primary care clinics. For more information, visit www.SaintMarysReno.com.

Responsibilities

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 supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. 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.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

• Licensed clinician in your state or;
• Grandfathered prior to April 1, 2015. Minimum 5 years' post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
• Minimum 5 years' experience in a Case Management position.
• Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
• Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

• CCM or obtained within 1year
• BS or BSN or related field preferred.
• Current BCLS certificate preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf