RN Case Management Services Director

RN Case Management Services Director

Mesa Arizona

Exp 2-5 yrs

Deg Bachelors

Relo

Bonus

Occasional Travel

Job Description

We provide complete acute care services including oncology, women's health, rehabilitation, emergency medicine, surgery and a nationally recognized Primary Stroke Center. A strong focus for us is orthopedics. Dedicated to joint replacement procedures, our orthopedic unit is recognized as one of the Top 100 Orthopaedic Programs in the U.S. by The Health Network and HCIA, Inc. We offer state-of-the-art technology including: iCare – an extra layer of monitoring in intensive-care units, robotic surgery, electronic medical records, a system designed to reduce complications during labor and delivery and a 10,000 square-foot, on-site childcare center.

This position is responsible for the development and implementation of case and utilization management programs and services. This position provides leadership, direction and support for Case Management Services in the pursuit for best practice to achieve quality outcomes, reduce costs, and shape and interpret the standards required to ensure a high degree of patient, physician and employee satisfaction. This position may also have responsibilities for other facility/entity-specific patient outcomes.

Essential Functions

*Plans, directs and monitors the case and utilization management program(s). Provides advice, counsel, feedback and coordination to promote a collegiality between staff, physicians and the leadership team.

*Ensures that development of case management services across the continuum leads to outcomes supportive of the organization’s strategic plan. Designs and implements processes to ensure appropriate care coordination in accordance with regulatory and standards of safety.

*Provides direction for multidisciplinary process improvement activities, including the establishment of performance measures to attain optimal clinical, operational, financial and satisfaction outcomes. Directs the collection, analysis and presentation of data on utilization patterns and other program outcomes.

*Directs personnel actions including recruiting, new hire actions, interviewing and selection of new staff, salary determinations, training, and personnel evaluations. This position also participates in the development of Case Management goals and objectives in accordance with company standards.

*Manages the financial and capital resources for case management services by monitoring operating revenue and expenses, establishing and maintaining cost control programs and developing and implementing new or revised programs and/or services. Develops and implements strategies to work with all external customers to ensure appropriate reimbursement.

*Develops and oversees the department budget in conjunction with corporate goals and objectives. This position is accountable for meeting annual budgetary goals.

*Assesses patient satisfaction in areas of responsibility; sets a high standard for staff and leadership to improve patient satisfaction as measured by survey scores.

Minimum Qualifcations

Requires a Bachelor’s degree in nursing or equivalent experience.

Requires Registered Nurse (R.N.) license in state worked. In an ambulatory setting, a CCM (Certified Case Mgr) must be obtained within 3 years of accepting position.

Must have considerable experience with appropriate age specific patient population in the area of responsibility as typically demonstrated through at least 2 years of management experience and two years of providing direct, clinical care in a patient setting.

Must possess demonstrated flexibility in responding to the needs of multiple constituencies with a service-oriented philosophy. Must also possess demonstrated skill in problem analysis, project management, contract negotiation, conflict resolution and oral/written presentation. Requires strong working knowledge of utilization management, care management, regulatory standards and reimbursement across the continuum of care.

Preferred Qualifcations

Master’s degree in nursing or business is preferred; Managed care experience is a plus; CCM (Certified Case Mgr).