Director Case Management

Job Title: Director of Case Management
Location: Richmond, VA
Facility: 64-bed Rehabilitation Hospital

Salary Range: $95,000 - $105,000 annually
Average Daily Census (ADC): 47-48 patients

Position Overview:

We are seeking an experienced and dynamic Director of Case Management to join our Senior Leadership Team. This is a fantastic opportunity for an individual with a strong background in healthcare case management and leadership, looking to lead a dedicated team of case managers in a fast-paced hospital environment. This position will be instrumental in managing the hospital's case management functions, ensuring efficient patient care transitions, and overseeing all aspects of utilization review and discharge planning.

As the Director of Case Management, you will report directly to the CEO and manage a team of 4 direct reports. This is a leadership role, and while you will not carry a full patient case load, you will be expected to carry a smaller assignment to assist when necessary and provide clinical expertise.

Key Responsibilities:

• Leadership and Management:

Lead the Case Management department, ensuring that all functions (utilization review, discharge planning, and patient care coordination) are performed efficiently and in alignment with hospital policies and best practices.
Manage, mentor, and support a team of 4 case managers to ensure they meet hospital standards and contribute to achieving positive patient outcomes.
Actively participate as a member of the Senior Leadership Team to influence strategic decision-making and ensure the hospital is delivering high-quality care.

• Utilization Review & Discharge Planning:

Oversee and optimize the utilization review process, ensuring that all admissions, continued stays, and discharges meet the necessary medical criteria and comply with insurance and regulatory requirements.
Work closely with physicians, nursing staff, and other healthcare professionals to facilitate smooth transitions of care, minimizing delays, and ensuring timely discharges.
Review patient care plans to ensure that all necessary resources are utilized efficiently and that patients receive appropriate care within the hospital setting.

• Compliance & Documentation:

Ensure that all case management activities comply with regulatory standards, including those set by CMS, Joint Commission, and other relevant authorities.
Oversee documentation and reporting related to case management activities, ensuring that all records are complete, accurate, and submitted in a timely manner.

• Collaboration with Other Departments:

Collaborate with clinical and administrative teams to promote integrated care and continuous improvement in patient care delivery.
Serve as a liaison between case management and other hospital departments to ensure that patient care goals are aligned across the organization.

• Patient and Family Advocacy:

Advocate for patients and families to ensure that they receive the necessary resources, education, and support throughout their care journey.
Address any patient or family concerns regarding care plans, discharge processes, and post-hospital needs.

• Continuous Improvement:

Identify opportunities for process improvements in case management workflows and contribute to the development of policies and protocols that enhance patient care and operational efficiency.

Qualifications:

• Education:

Must have either a Bachelor of Science in Nursing (BSN) or a Bachelor’s degree in Social Work (SW).
Active licensure (RN or Social Worker) is preferred.

• Experience:

A minimum of 1-2 years of hospital-based case management experience is required.
Experience with utilization review and discharge planning is highly preferred.
Previous leadership experience in a healthcare setting is required.

• Skills and Competencies:

Strong understanding of case management processes, including clinical assessments, discharge planning, and utilization review.
Excellent communication and interpersonal skills with the ability to collaborate effectively across various departments.
Proven leadership abilities with a focus on team development and fostering a supportive work environment.
Solid understanding of healthcare regulations and compliance standards, including CMS and The Joint Commission requirements.
Ability to problem-solve and make decisions in complex and fast-paced environments.
Proficiency in electronic health record (EHR) systems and case management software.

Additional Information:

• Work Environment:

The Director of Case Management will work in a collaborative and supportive hospital environment, alongside an experienced leadership team committed to high-quality patient care.
This position offers a fantastic opportunity to contribute to the ongoing development of our case management department and the hospital as a whole.

• Compensation:

The competitive salary for this role ranges from $95,000 to $105,000 annually, based on experience and qualifications. Benefits include healthcare, retirement, paid time off, and professional development opportunities.

If you are a driven, compassionate healthcare leader with experience in case management, we would love to hear from you.

Job Type: Full-time

Pay: $95,000.00 - $105,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $95,000 - $105,000