Director Case Management

Job Description

Job Description

The Director of Case Management maintains a caseload of residents. The Director of Case Management provides direct supervision to all Case Managers and Case Manager Assistants. The Director of Case Management will collaborate with the Director of Sales and Marketing to develop and maintain ongoing relationships with third-party Management systems.

JOB-SPECIFIC RESPONSIBILITIES :

• Oversees the Case Management department; provides direct supervision to all Case Managers and Case Manager Assistants.
• Completes admission forms for each resident. If needed, help the Admissions team ensure the admissions office, residents, or appropriate support persons receive a copy of the admissions form.
• Assembles treatment team to conduct admissions conferences with residents and / or support persons.
• Assures a secure and comforting welcome to residents / support person upon admission.
• Upon resident's admission, contact external payor source case manager / representative of the resident's actual admission and reviews schedule for clinical updates.
• Completes Case Management Admission Assessment of the resident within 24 hours or by the next business day of admission.
• Liaisons with the residents attending physician and medical staff to ensure resident's medical needs are met.
• Liaisons with the Program Director and treatment team members to ensure resident's program and service of treatment accurately focused on resident's deficits.
• Conduct at least weekly contact and documentation with payor sources and family / support persons of residents.
• Initiates regular communication with Program Director to ensure residents are appropriately served.
• Coordinates with the multidisciplinary team and Program Director to develop the resident's treatment plan.
• Meets with medical staff to receive weekly medical updates and arrange for diagnostics, equipment, supplies, or medical services as ordered.
• Complete Clinical Pre-assessments on residents as needed (only on campus).
• Provide consultation and support to other case managers as needed.
• Provides third-party payor sources with appropriate clinical updates per the agreed-upon reporting schedule.
• Presents a positive and helpful working relationship with all external case managers / representatives and community agencies, demonstrating effective internal case management.
• Acquires appropriate information to address payor denials necessary to receive payment due.
• Maintains initial and ongoing documentation in the medical record regarding resident's status related to treatment progress, family issues, estimated length of stay, and discharge needs.
• Utilize Meditech documentation print-out of all disciplines for treatment and, together with any updates, may forward this document to payor sources for official clinical progress.
• Acquires necessary community resources to meet the resident's needs before discharge.
• Coordinates discharge with resident's family / support persons, payor sources, and community services to ensure a safe, timely, and effective discharge.
• Verified community services have been arranged to ensure a resident's timely and uninterrupted discharge transition is to the most appropriate setting.
• Resolves resident's family or support person's complaints or concerns to appropriate team member and follows up to ensure resolutions are acceptable to all parties.
• Exhibits professional, positive demeanor to residents and relevant parties, offering constructive communication, cooperation, and assistance to ensure a satisfactory resident stay of treatment.
• Provides timely information / feedback to the designated supervisor on any relevant resident / family / support person / payor source that could jeopardize the resident's treatment, family / support person / payor sources, or discharge planning issue.
• Provide marketing support, including facility tours, conference coverage, and follow-up with established contacts.
• Designs Case Management Specific Key Performance Indicators (KPIs) and holds the department to those standards.
• Attends weekly L10 meetings and brings issues up for discussion to the NNC Executive Team to solve.
• Performs other duties as assigned.

POSITION QUALIFICATIONS :

EDUCATION :

Bachelor's Degree in health care field required.

Registered Nurse (RN) preferred.

Master's Preferred

EXPERIENCE :

Experience in case management

Strong background in healthcare

Three years of leadership experience.

LICENSURE / CERTIFICATION :

Current Certified Case Manager (CCM) certification.

Current AHA BLS certification.