RN Case Management Supervisor — Utilization & Care

Baptist Memorial Health Care Corporation; Bluecutt Estates (MS); On-site; USD 75,000 - 105,000; Full time

Job summary

The Baptist Memorial Health Care Corporation is seeking an Assistant Director of Case Management to support Precertification, Case Management and Social Services across the patient care continuum.

In this role you will lead case management staff, set goals, coordinate care, assess needs, plan and monitor delivery of services, and collaborate with medical staff to optimize outcomes and reduce costs while maintaining patient advocacy.

Responsibilities

• Assist Director of Case Management with the general operations of Precertification, Case Management and Social Services as well as other functions as assigned.
• Provides Leadership sets goals and establishes priorities for Utilization Review/ Case Management Staff for department efficiency.
• Interacts and collaborates with physicians and their office staff, review entities, third party payers, patient/family and other case managers.
• Coordinates care through assessing, planning, monitoring, implementing and evaluating delivery of services using an integrated approach and appropriate resources.
• Assures verification of benefits, eligibility, and pre-authorization of services and performs continued stay reviews.
• Provides education/consultation to the health care delivery team/patients/families about care options, community resources, insurance benefits.
• Utilizes payer criteria to determine level of care by reviewing records, physician discussion and discharge needs.
• Participates in QI /PI activities and identifies and reports issues for improvement.
• Communicates policies to assure patient rights and respect dignity, culture and values.
• Assume responsibility for personal growth and development by attendance and/or participation in in-services and continuing education programs.
• Performs other duties as assigned to support hospital mission and service quality.
• Actively participates in promotion of Service First activities and goal achievement.
• Participate in meetings/conferences, attend in services and then teach staff.
• Implements and monitors new policies, procedures and regulations.
• Coordinate operations of the Precert, Case Managers and Social Workers including monitoring productivity.
• Assist with staff meetings and provide educational opportunities.

Job description

The Baptist Memorial Health Care Corporation is seeking an Assistant Director of Case Management to support Precertification, Case Management and Social Services across the patient care continuum.

In this role you will lead case management staff, set goals, coordinate care, assess needs, plan and monitor delivery of services, and collaborate with medical staff to optimize outcomes and reduce costs while maintaining patient advocacy.