What are the responsibilities and job description for the Case Management Director position at AdventHealth Hendersonville?
All the benefits and perks you need for you and your family:
- Benefits from Day One
- Paid Days Off from Day One
- Student Loan Repayment Program
- Career Development
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule:
Shift :
Location: 100 Hospital Drive, Hendersonville, NC 28792
The community you’ll be caring for: AdventHealth Hendersonville
- Convenient access, with locations across Western North Carolina
- Beautiful mountain scenery
- Historic towns and cities full of specialty shops, art galleries and unique restaurants
- Fresh produce available at farmers’ markets and U-picks
- Special events to enjoy in every season
T he role you’ll contribute:
Supervise Case Managers and Discharge Planners who follow patients from pre-admission through discharge to home, nursing/rehab facility or home care program. Assure appropriate discharge planning for the patient and family and comply with all regulatory and financial guidelines. Oversee utilization review, house supervisor and discharge planning
The value you’ll bring to the team:
- Maintains and utilizes current knowledge of utilization review criteria and reimbursement guidelines to serve as a resource person for the Care Management Department. Acts as a resource for medical staff, interpreting requirements of federal, state and third-party payer guidelines for coverage.
- Identifies potential for over and underutilization of hospital resources, non-acute and potentially avoidable days, takes appropriate interventions, trends and reports data.
- Collaborates with nursing and other clinical staff to achieve optimal clinical outcomes.
- Conducts multidisciplinary case conference to promote communication about patient status and future plans and to assure coordination of care.
- Demonstrates appropriate clinical knowledge in order to assist physicians in providing complete documentation of severity of illness and intensity of services in order to assure that criteria for acute hospitalization are met. Acts as a liaison with physicians to assure that aspects of treatment are fully documented and to assist in identifying other options for care when acute hospitalization is no longer required. Interacts appropriately with physicians, providing information, suggesting alternatives, and assisting in securing timely referrals.
- Secures physician advisor reviews on a timely basis in cases of potential denial of medical necessity for admissions or continued stay. Provides feedback regarding potential risk and participates in the process of delivering notices of non-coverage.
- Continually evaluates opportunities to make the case management system more effective. Identifies suggested improvements to the system by using information from outcomes analysis.
- Promotes case management through role modeling and the education of other staff members on case management benefits and concept.
Qualifications
The expertise and experiences you’ll need to succeed:
- Master's in Healthcare, Leadership or Business Required
- 2 Medical and surgical experience Required
- 4 Supervisory or leadership experience Preferred
- RN - Registered Nurse - State Licensure and/or Compact State Licensure Current North Carolina state licensure Required
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Case Management
Organization: AdventHealth Hendersonville
Schedule: Full-time
Shift: 1 - Day
Req ID: 25015662
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
