What are the responsibilities and job description for the Director, Case Management position at Gila River Health Care?
Position Summary : Directs and oversees the daily operations of the Case Management department. Supervises subordinate staff by making employment decisions and providing education. Prepares and develops annual budget and monitors and approves expenditures. Oversees utilization reviews and caseload audits. Ensures all department activities are timely, accurate, and compliant with established regulations and guidelines. Participates in a variety of committees to enhance the quality of patient care services. Critical Tasks : Supervises the work of assigned personnel by assigning and reviewing work, providing guidance and training, and conducting performance evaluations.Develops and implements case management programs, including utilization review and admission or discharge planning.Plans, develops, and manages department strategies and operational budgets. Prepares and submits budget and related reports. Forecasts expenses and approves expenditures. Plans and implements performance improvement strategies for case management.Works collaboratively with Case Managers to serve patients and provides best practices consultation and guidance.Works collaboratively with Emergency and Inpatient directors to assists and facilitate patient's needs such as transfers and admissions of patients in ED and Inpatient. Prepares and distributes status and statistical reports of activities. Oversees utilization reviews and caseload audits.Ensures compliance with patient medical records and information privacy regulations, including medical data confidentiality and security.Acts as liaison between clients and outside agencies, institutions, homes, and facilities. Coordinates with various departments regarding referrals, screenings, and treatments. Collects, analyzes, and responds to medical and healthcare data from internal and external sources.Receives and responds to patient complaints and researches issue for corrective action and identifies alternative solutions, as needed.Participates in a variety of meetings and committees to collaborate on enhancement opportunities for patient care services.Performs other job-related activities as requested.Required Qualifications : Bachelor's Degree in Social Work, Nursing, or a closely related field of study required; Master's Degree preferred.5 years of previous Case Management or Nursing experience. Commission for Case Manager Certification (CCMC) within 1 year in position required Registered Nurse Licensure in AZ or qualified Compact Licensure if applicable.Current and valid cardiopulmonary resuscitation (CPR) certification or ability to obtain certification within 30 days of hire. Demonstrated ability to relate to diverse cultures and specifically the Gila River Community and / or other Native American cultures.
