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Director - Case Management Services

St. Bernard Hospital

Job Description

Summary of Position:


The Director of Case Management Services directs the operations and functions of the department in the performance of utilization management and social services. H/she manages RN Case Managers, as well as Social Workers.


Duties and Responsibilities:


Clinical:


1. Plan and direct the operational activities of the Case Management Services Department, assuming responsibilities for quality and productivity of utilization review and discharge planning.


2. Oversee supervision of the Utilization Review Coordinators, Clinical Case Managers and Social Worker/Discharge Planners.


3. Maintain relationships with physicians, department heads, administrators, and clinical coordinators to support intra-departmental goals and advise on activities pertaining to utilization and discharge planning.


4. Ensure the Utilization Review Coordinators and Clinical Case Managers initiate timely communication with external reviewers to coordinate clinical reviews, discharge planning, and transfer needs.


5. Ensure accurate and consistent monitoring and evaluation of utilization activities.


6. Ensure accurate and consistent monitoring and evaluation of utilization activities. Report activity and findings to the Utilization Review Committees and other departmental meetings, as appropriate.


7. Provide job performance feedback to staff at least annually and as needed.


8. Assist staff with difficult discharge placements and physician issues with utilization requirements.


9. Review all charts reviewed by Health Systems of Illinois (HIS) and alert Hospital units, Medical Records, and the Mental Health Department with issues of missing documents.


10. Serve as a hospital liaison with Health Systems of Illinois for concurrent and retrospective review.


Administrative:


1. Responsible for the interviewing, hiring, and training employees; appraising performance; disciplinary actions; addressing complaints;and resolving issues.


2. Responsible for continuing staff development.


3. Develop and implement polices and procedures for the Case Management Services Department not covered by Hospital policies.


4. Prepare and execute program budget.


5. Oversee program expenditures including labor, benefits,supplies, equipment, etc.


Quality Improvement:


1. Ensure proper procedures are followed with regards to record keeping.


2. Coordinate the collection of documentation of clinical outcomes and maintain database and reporting systems.


3. Maintain highest level of departmental cleanliness and safety.


4. Maintain safety of property and patient under treatment. Perform related management or professional duties as required by the Administration,physician, or dictated by patient’s needs.


5. Study current trends and new developments in Clinical Case Management.


6. Direct monthly departmental meetings.


7. Attend relative workshops,conferences, and seminars.


8. Participate in appropriate professional and/or specialty organizations.


9. Any other duties as required or requested.


A comprehensive benefits package is offered including Vision, Dental, 403B, and Flexible Spending Account (FSA)! Free parking!


Job Type: Full-time

Job Requirements

Required Education:


Bachelor’s degree in Nursing.


RN in the state of Illinois


Desired Education:


Master’s degree in Nursing or related field. Certification in healthcare quality.


Required Experience:


Minimum of two (2) years of utilization management experience.


Minimum of two (2) years of clinical practices with supervisory experience.


Desirable Experience:


Minimum of three (3) years of utilization management experience in a health care setting.


Minimum of five (5) years of clinical practices with supervisory experience in a health care setting.

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Job Snapshot

Location US-IL-Chicago
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Health Care

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Terms & Conditions
Snapshot
St. Bernard Hospital
Company:
US-IL-Chicago
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description

Summary of Position:


The Director of Case Management Services directs the operations and functions of the department in the performance of utilization management and social services. H/she manages RN Case Managers, as well as Social Workers.


Duties and Responsibilities:


Clinical:


1. Plan and direct the operational activities of the Case Management Services Department, assuming responsibilities for quality and productivity of utilization review and discharge planning.


2. Oversee supervision of the Utilization Review Coordinators, Clinical Case Managers and Social Worker/Discharge Planners.


3. Maintain relationships with physicians, department heads, administrators, and clinical coordinators to support intra-departmental goals and advise on activities pertaining to utilization and discharge planning.


4. Ensure the Utilization Review Coordinators and Clinical Case Managers initiate timely communication with external reviewers to coordinate clinical reviews, discharge planning, and transfer needs.


5. Ensure accurate and consistent monitoring and evaluation of utilization activities.


6. Ensure accurate and consistent monitoring and evaluation of utilization activities. Report activity and findings to the Utilization Review Committees and other departmental meetings, as appropriate.


7. Provide job performance feedback to staff at least annually and as needed.


8. Assist staff with difficult discharge placements and physician issues with utilization requirements.


9. Review all charts reviewed by Health Systems of Illinois (HIS) and alert Hospital units, Medical Records, and the Mental Health Department with issues of missing documents.


10. Serve as a hospital liaison with Health Systems of Illinois for concurrent and retrospective review.


Administrative:


1. Responsible for the interviewing, hiring, and training employees; appraising performance; disciplinary actions; addressing complaints;and resolving issues.


2. Responsible for continuing staff development.


3. Develop and implement polices and procedures for the Case Management Services Department not covered by Hospital policies.


4. Prepare and execute program budget.


5. Oversee program expenditures including labor, benefits,supplies, equipment, etc.


Quality Improvement:


1. Ensure proper procedures are followed with regards to record keeping.


2. Coordinate the collection of documentation of clinical outcomes and maintain database and reporting systems.


3. Maintain highest level of departmental cleanliness and safety.


4. Maintain safety of property and patient under treatment. Perform related management or professional duties as required by the Administration,physician, or dictated by patient’s needs.


5. Study current trends and new developments in Clinical Case Management.


6. Direct monthly departmental meetings.


7. Attend relative workshops,conferences, and seminars.


8. Participate in appropriate professional and/or specialty organizations.


9. Any other duties as required or requested.


A comprehensive benefits package is offered including Vision, Dental, 403B, and Flexible Spending Account (FSA)! Free parking!


Job Type: Full-time

Job Requirements

Required Education:


Bachelor’s degree in Nursing.


RN in the state of Illinois


Desired Education:


Master’s degree in Nursing or related field. Certification in healthcare quality.


Required Experience:


Minimum of two (2) years of utilization management experience.


Minimum of two (2) years of clinical practices with supervisory experience.


Desirable Experience:


Minimum of three (3) years of utilization management experience in a health care setting.


Minimum of five (5) years of clinical practices with supervisory experience in a health care setting.

Director - Case Management Services Apply now