What are the responsibilities and job description for the Director of Case Management position at Coalinga Regional Medical Center?
POSITION SUMMARY
The Director of Case Management oversees the daily operations and regulatory requirements of the Case Management Department, while supporting the Pre-Authorization team. The Director contributes to the facility’s mission by assessing and improving Case Management and Pre-Authorization practices, focusing on workflow, length of stay (LOS), and throughput. They lead and educate the team, identify improvement opportunities, and collaborate with leadership to optimize resource utilization and patient care standards. The Director works with the interdisciplinary team to ensure coordinated services and cost-efficient, quality patient outcomes across the continuum of care, and may also serve as a Pre-Authorization Nurse as needed.
POSITION QUALIFICATIONS
The ideal candidate is a Registered Nurse with a current state license and a Bachelor’s degree in nursing, administration, or a healthcare-related field. An Accredited Case Manager certification is preferred. The candidate should have 3-5 years of management experience, including at least 2 years in case management, with preferred experience in quality, pre-admissions, long-term acute care, and rehabilitation. Strong leadership, interpersonal, and communication skills are essential, along with proficiency in English and computer skills. The candidate should be able to work independently and apply principles of supervision and administration effectively.
RESPONSIBILITIES
- Develop, implement, and evaluate Case Management processes and protocols to enhance patient care delivery while maintaining compliance with all regulatory standards
- Lead the Case Management team in providing patient-centered care, ensuring timely, efficient, and appropriate utilization of services.
- Collaborate with physicians, nursing staff, and other healthcare professionals to coordinate care plans, discharge planning, and ensure a smooth transition for patients across care settings.
- Supervise, mentor, and train Case Management staff, ensuring continuous development and adherence to best practices
- Ensure compliance with state and federal regulations, accreditation standards, and organizational policies related to Case Management and Pre-Authorization services
- Oversee the management of patient documentation, ensuring accuracy and completeness of case files and adherence to legal and regulatory requirements.
- Participate in the development of strategic initiatives aimed at improving operational efficiency, patient satisfaction, and resource utilization
- Facilitate regular meetings with the interdisciplinary team to discuss complex cases, coordinate care plans, and address any potential barriers to care
- Maintain up-to-date knowledge of current healthcare trends, regulations, and technologies to ensure the department’s practices remain effective and compliant.
