What are the responsibilities and job description for the Director of Case Management position at Mercy Health?
DIRECTOR OF CASE MANAGEMENT AND SOCIAL WORK| Lima, OH
St. Rita Medical Center
Position Summary
Responsible for directing, planning, organizing, and managing functions and resources for the Care Management Department. Works closely with Care Management Leadership and colleagues to implement leading practices that support a progressive, data- driven, outcomes-oriented care management model. Fosters integration and strong collaborative partnerships with nursing, quality, hospitalist, and market / facility leadership related to clinical integration activities in order to optimize high quality, cost- efficient care in a timely manner that is patient focused and seeks to improve the experience of care.
Essential Functions
- Collaborates with CM leadership and colleagues to achieve leading, standardized practices and processes related to care transition management including readmission prevention, length of stay, advance care planning, daily tam rounding, and patient satisfaction / experience related to care transitions.
- Supports national standards for care management scope of service : Education, Care Coordination, Compliance, Transition Management and Resource Utilization.
- Works closely with community health, ambulatory and population health partners in efforts to support patients across the care continuum. Collaborates with ambulatory and post-acute providers / staff to ensure seamless transitions of care. Works closely with post-acute network partners on key initiatives and efforts to reduce unnecessary PAC utilization, when safe and appropriate.
- Partners with facility physician leader to optimize the Utilization Management Committee, providing actionable data related to utilization opportunities identified through qualitative data, and quantitative data analytic platforms such as Quality Advisor, and other facility and system data resources.
- Collaborates with our Ensemble partners to support denial prevention, patient classification and compliance for optimal performance and adheres to SOW related to BSMH responsibilities.
- Directs daily operations to achieve effective utilization of personnel resources consistent with patient and ministry needs. Directs development of annual departmental goals and objectives, aligns with system CM goals and objectives.
- Ensures compliance with federal, state, and local regulations and accreditation requirements impacting care management service. Routinely audits and tracks for quality assurance, analyzes data to identify opportunities for performance improvement. Holds staff accountability to follow CM processes to support quality, resource utilization and compliance.
Requirements
