Director Of Case Management

Signing Bonus: $20,000 sign-on bonus and $5,000 Relocation for a 3-year commitment

• Relocation Package: Full

Job Description

Our client is seeking a Clinical Case Manager to provide ongoing support and expertise in patient care management. This role involves conducting comprehensive assessments, planning, implementing, and evaluating individual patient needs in a healthcare setting. The overall goal is to enhance the quality of patient management and satisfaction, promote continuity of care, and ensure cost-effectiveness by integrating case management, utilization review, and discharge planning processes. The Clinical Case Manager will be responsible for the care coordination and discharge planning for all patients.

Key Responsibilities

• Promote the mission, vision, and values of the organization.
• Assist in developing departmental goals, standards, and objectives that align with the strategic plan and organizational vision.
• Integrate social services and case management functions with various hospital departments, external service organizations, and healthcare facilities.
• Conduct concurrent medical record reviews using established criteria and guidelines approved by medical staff, state agencies, and regulatory bodies.
• Act as a patient advocate by investigating and reporting adverse occurrences and educating staff on resource utilization, discharge planning, and psychosocial aspects of healthcare delivery.
• Mobilize resources and conduct interviews as necessary to achieve desired clinical outcomes within the designated timeframes.
• Ensure the appropriate utilization of services from admission through discharge.
• Evaluate patient satisfaction and quality of care provided.
• Initiate and present denial letters as required.
• Assess patient care needs across the continuum of care, including diagnosis, procedures, and treatment plans.
• Communicate regularly with physicians to maintain effective working relationships.
• Assist physicians in managing costs per case while achieving the desired patient outcomes.
• Introduce the clinical case manager role to patients and their families, explaining the process and providing contact information.
• Facilitate interdisciplinary patient care rounds and conferences to review treatment goals, optimize resource utilization, provide family education, and address post-hospital needs.
• Collaborate with clinical staff to develop and execute care plans that achieve treatment goals.
• Contribute to the development and implementation of patient care policies and protocols to address special patient needs or cases.
• Coordinate social services for patients and families, providing support to manage the impact of illness and ensure optimal use of healthcare resources.

Must-Haves

• Graduate of a Program in Nursing at Bachelors of Science level or higher required
• Certifications: BLS required upon hire
• Arizona Registered Nurse and/or Compact State Registered Nurse required
• Minimum of 2 years as director of Case Management in a critical care hospital required

Nice-To-Haves

• CCM or ACM Certification preferred
• Master's degree preferred
• 5 years in Case Management leadership or leadership in critical care hospital upper management