What are the responsibilities and job description for the Director of Case Management position at Desert Regional Medical Center?
Desert Regional Medical Center is a 385-bed acute-care hospital classified as a stroke receiving center and level 2 trauma facility with an innovative, patient centered and evidence-based Rehabilitation Services Department. Our compassionate team provides a wide range of inpatient and outpatient services, including acute care rehabilitation, joint replacement & spinal surgery, neurosurgery, ICU, Telemetry, step-down care, skilled nursing, as well as outpatient therapy, hand and lymphedema clinics.
General Duties:
The individual in this position has overall responsibility for operational management of the Case Management Department, Social Services and Bed Control; including staffing, budgets and plans.
The individual’s responsibilities will include, but not be limited to the following activities:
a) Complying with relevant Tenet policies including Case Management and Clinical Determination Policies b) implementing and revising the UM Plan and promoting cooperation with utilization review standards by the medical staff c) Maintaining / facilitating communication between the case management department and the physician advisor on a regular basis regarding utilization review and/or quality issues d) Maintaining / facilitating communication between the case management department and the physicians as well as other members of the healthcare team e) analysis of reports: LOS, avoidable days, disputes, InterQual and associated metrics f) Responsible for implementation and compliance with all policies and regulations relating to the functioning of the case management department g) and all other duties as assigned
Attends a workshop webinar led by PMI Case Management leadership or designee that includes the Tenet Case Management Model and other topics specific to role and responsibilities.
Information used to perform job: patient data, healthcare staff documentation related to patient care, regulatory and payor requirements, budgetary and operations data
Software used to perform job: eCCM: Clinical data interface, InterQual, Case Management documentation, secure faxing, Avoidable Day tracking, Patient Medical Record and HPF, hospital specific Clinical Software, Enterprise Reporting: Decision Support reports, PMI reports, Care Discovery, Position Control
Shift: Days
Hours:
2503003495
