Director of Case Management - Watertown, United States - The National Coalition of Healthcare Recruiters

The National Coalition of Healthcare Recruiters Watertown, United States

2 weeks ago

Description

(Only QUALIFIED Healthcare Professionals accepted)

Nurse Managers - Director of Case Management &

Discharge Planning:
Direct Hire
Full-Time (Days)
Competitive Salary & Benefits Package

Director for Case Management & Discharge planning collaborates and facilitates Case Management and Discharge Planning processes in order to assess, plan, implement, coordinate, monitor and evaluate options and services to meet and individuals' health care needs through communication and coordination of resources to promote quality, cost effective outcomes.

The position requires a high level of organizational skills along with the ability to set assignment priorities and work independently with a minimum amount of supervision.

The person must be able to tactfully interact with patients, families, medical providers, the multidisciplinary care team and outside resources.

A high regard for confidentiality is required.

Principal Duties and Essential Functions:
Current NYS RN license
Knowledge of UR Conditions of Participation including objective criteria for appropriateness of admission and various levels of care.
Continued support, participation and facilitation of Multidisciplinary Rounding Processes
Facilitating clear concise communication processes between the facility and payers
Maintaining positive relationships with long term providers, home care agencies, social service agencies, PCP offices, Hospice, and other community resources
Computer literate in Excel, Word, Powerpoint
Excellent verbal and written communication skills
Knowledge of CMC regulations surrounding Discharge Planning and requirements for continuum of care
Strong patient and family advocacy
Knowledge of Family Healthcare Decision Act and implications as well as strong understanding of Advanced Directives
Oversight of inpatient denial management
Ability to collaborate and communicate among disciplines to problem solve
Knowledge of payer intricacies in relation to patient status and level of care
Oversight of management of patient cases both in the inpatient, observation and outpatient (BHU) setting to ensure patients are receiving treatment and care across the continuum
Oversight of PRI (Patient Review Instrument) and Screen completion
Oversight of ALC population and facilitation of family discharge planning meetings as necessary
Collaboration with Readmission reduction via multidisciplinary team
Participation in current hospital initiative task forces
Participation in Revenue Cycle work group and Corporate Compliance Committee
Presence in outside advisory board work with community resources
Quarterly review of PEPPER report
Facilitating staff communication including staffing meetings
Staff support and advocacy, reinforcement of patient and family education regarding discharge planning and regulations processes
Direct responsibility for budgets of three departments
Supervision of approximately 25 employees including scheduling and timekeeping management
Annual staff evaluations, goal setting, management of job requisitions in Taleo for position control
Knowledge of accreditation and regulatory requirements
Direct reporting to Medical Management committee regarding UR|Case Management processes
Bridging gaps for uninsured| underinsured individuals to access payment for needed care and treatment in the post-acute care setting
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