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)
POSITION PURPOSE:
Responsible for the day-to-day delivery of individual support program services to assigned case load in accordance with Federal, State, and facility codes, regulations, guidelines and expectations.
ESSENTIAL FUNCTIONS OF POSITION:
EDUCATION / REQUIREMENTS:
Is one of the following: A doctor of medicine osteopathy, a registered nurse, an individual who holds at least a bachelor’s degree in a professional category specified in the Federal regulation 483.430 paragraph (b)(5) or designated as a human services professional that has at least a bachelor’s degree in a human services field (including, but not limited to: sociology, special education, rehabilitation counseling, and psychology).
At least one year’s experience working with intellectual disabilities or other developmental disabilities.
When State licensure and/or certification is required for the professional degree held by the QIDP, the license must be current and unencumbered.