Case Management Director oversees a staff of case managers responsible for patient care coordination. Develops and implements case management programs, including utilization review, intake or discharge planning, and managed care contracting or negotiation. Being a Case Management Director evaluates patient care data to ensure that care is provided in accordance with clinical guidelines and organizational standards. Seeks treatments that balance clinical and financial concerns with the family's needs and the patient's quality of life. Additionally, Case Management Director contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care. Typically requires a bachelor's degree. Typically reports to top management. May require Registered Nurse (RN). The Case Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Case Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
Minimum Qualifications:
5 of the most recent 7 years’ working in a Case Management leadership capacity specifically managing Utilization Review and Clinical Audits & Disputes
BSN
Licensure, Registration, Certification:
One of the following:
*Infirmary Health abides by the NLC requirements and guidelines for the state of Alabama
Desired Qualifications:
MSN
Desired Licensure, Registration, Certification
American Academy Case Management certification
(AACM)
Provides strategic minded and outcome-based focus for the overall operations of system-wide Case Management, including but not limited to Care Coordination, Special Care and Bundles, and Care navigation, which meet IH's standards of quality, efficiency, and desired outcomes. Develops acute care and post-acute care coordination strategies to optimize utilization.