Director Case Management vacancy at North Austin Medical Center in Austin

North Austin Medical Center is at the momment seeking for Director Case Management on Fri, 31 May 2013 12:59:48 GMT. POSITION SUMMARY: The Director of Case Management is responsible for the day to day operations of the department. The Director will develop, implement, and review the Utilization Management Plan annually. The Director is responsible for coordinating and facilitating multiple resources, internal and external, into a unique and single approach to care coordination for each patient assigned case...

Director Case Management

Location: Austin Texas

Description: North Austin Medical Center is at the momment seeking for Director Case Management right now, this vacancy will be placed in Texas. Detailed specification about this vacancy opportunity kindly see the descriptions. POSITION SUMMARY:
The Director of Case Management is responsible for the day to day operations of the department. The Director will develop, implement, and review the Utilizat! ion Management Plan annually. The Director is responsible for coordinating and facilitating multiple resources, internal and external, into a unique and single approach to care coordination for each patient assigned case management services.

The Director will identify and implement processes that support and promote efficient patient throughput across the healthcare continuum resulting in optimal clinical outcomes, appropriate utilization of resources, and appropriate and accurate reimbursement.

The Director will provide leadership, communication, and supervision to the department staff to ensure HCA and facility strategy is operationalized.

PERFORMANCE EXPECTATIONS:
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Demonstrates leadership, collaboration, and effective communication skills in directing and managing the assigned fiscal and human resources in support of facility goals and objectives: establishes and communicates department goals and objectives;

manag! es personnel and assesses staff accountabilities; care coordin! ation; resource management; discharge planning; utilization management; department productivity targets;

employee, patient and physician satisfaction;

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Identifies and implements resource reduction strategies consistent with facility strategic plan with a focus on quality outcomes, reduction of length of stay, medical necessity and level of care

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Develop, implement, and review the Utilization Management Plan annually:

holds self and others accountable for successfully achieving approved plans; develops, monitors, and review action plans.

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Identify and champion new programs, system processes, and company initiatives which improve clinical and financial outcomes

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Directs department activities to minimize account denials, opportunity days and variances in length of stay; works collaboratively with colleagues to ensure resources are optimized

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Performs data analy! sis related to Case Management metrics; develops, implements and monitors action plans related to denials, avoidable days, LOS, QIO data (PEPPER reports, et al), and other identified case management metrics

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Provides feedback to Division Case Management Director on issues related to department operations:

offers input to Division Director on managed care contracting issues; best demonstrated practices; process improvement and utilization management activities; barriers to achieving goals and objectives of initiatives; participates in HCA Case Management and Division initiatives

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Demonstrates a commitment to teamwork and cooperation; communicates accurate information timely; collaborates with Physician Advisor; integrates case management, social services, utilization management, and discharge planning activities

Proceeds on Director’s initiative, in compliance with HCA standards, professional

standards of p! ractice and policy and procedure, to resolve identified issues

! ·

Directs activities to identify and provide for the needs of the under resourced patient population to include patient education activities, patient assistance programs, and community based resources

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Develops and revises, implements, monitors, and evaluates processes to ensure

outcomes are

achieved related to managed care contracts; appropriate authorizations or determinations of medical necessity for all payers sources are obtained and documented

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Initiates and facilitates collaboration with hospital staff, PAS, managed care with a goal of contract compliance and decreasing payer denials or non-medically necessary days at the facility level

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Develop, review, and implement policy and procedure

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Identifies process improvement opportunities; develops, revises,

implements, and monitors action plans

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Collaborates with physician advisor and ! medical staff to ensure

quality outcomes and patient throughput are maximized while supporting a balance of optimal care and appropriate resource utilization.

·

Provides leadership to and actively participates with facility staff to identify, implement, or enhance Case Management programs consistent with HCA and facility strategy

·

Implements and monitors regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives related to Case Management services; provides regulatory and compliance updates to staff, provides standards of practice updates, initiates / drives process changes to ensure compliance

to such regulations and quality initiatives as it relates to Case Management

·

Performs staff supervision to validate policy, procedure and standards are met; collaborates with Division Director prior to performing wide-spread records audits

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Provides input to man! aged care department on utilization management activities and communica! tes to staff

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Assesses learning needs of social worker and case managers:
provides for on-going educational needs

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Oversees utilization management committee functions and effectives

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Coordinates department functions to ensure proper coding for the billing of provider liable claims with the PAS, HIM and Nurse Auditor

WORK ENVIRONMENT:
This position operates within the confines of the hospital building and a general office environment.

Hours and shifts may vary to include holidays, weekends and evenings. On-call may be required.

SUPERVISES:
Case Managers, Social Workers, Clerical Staff

Qualifications

POSITION QUALIFICATIONS:
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RN with current state licensure required, BSN preferred

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5 years Nursing Case Management experience required; 2 years Director or Supervisor experience preferred

·
Certification in Case Management, Nursing, or Utilization Review

preferred

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Ability to establish and maintain collaborative and effective working relationships

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Ability to communicate effectively in oral, written and electronic formats

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Demonstrates analytical and critical thinking abilities with pro-active decision-making, problem solving and negotiation skills
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to North Austin Medical Center.

If you interested on this vacancy just click on the Apply button, you will be redirected to the official website

This vacancy starts available on: Fri, 31 May 2013 12:59:48 GMT

Apply Director Case Management Here