DIRECTOR OF CASE MANAGEMENT
SUMMARY OF RESPONSIBILITIES:
Responsible for coordinating and facilitating multiple resources, internal and external, into a unique and single approach to care coordination for each patient receiving case management services on both the McLeod Regional and Mcleod Darlington campus. 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. Will develop policies and procedures, audit and monitoring programs, and educational documents. Will perform risk analysis and issue resolution. Will develop, implement, and review the Utilization Management Plan annually. Will provide leadership, communication, and supervision to ensure McLeod Regional Medical Center strategy is operationalized. Responsible for project planning, process improvement and implementation. Plays a vital role in staff development by developing and executing plans for complex projects including any new process and maintenance of existing best practice. Responsible for tracking changes and minimize variability throughout the change process. Track the impact and continuously analyze trends for the department in order to deliver better operational readiness and overall outcomes. Work with the AVP of CM to assess risks, provide escalation management, balance the business needs versus technical and/or cost constraints, and encourage risk-taking behavior to maximize business benefit.
Bachelors of Nursing required; Current license as Registered Nurse in South Carolina required; Certification in Case Management or Utilization Review preferred.
Minimum 3 years of hospital management experience required; Minimum 3 years of case management experience required; Minimum 3 years of compliance related experience preferred
DEPARTMENT: Case Management