The Director of Case Management is responsible for planning, organizing, coordinating, managing, implementing, evaluating, and developing the Care Management department. The Director of Case Management guides and directs patient care units and other hospital departments to formulate an interdisciplinary approach to Case Management, while also serving as a resource for all staff to encourage and promote excellent care and safety standards. The Director of Care Management develops and integrates strategies to enhance the quality of care for patients, maintain proper length of stay, improve patient satisfaction and improved healthcare outcomes.

Essential Duties and Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

• Supervise the performance of Case Management staff members including the Bundle Navigator and the Hope program employes
• Evaluate staff performance and identify areas of strength and weakness, conducting recognition and/or disciplinary measures as needed
• Provide yearly performance appraisals to staff
• Direct the overall activities of the Case Management and implement efficiency measures
• Prepare and maintain staff schedules and approve time off requests for team members; approve Kronos before submitting
• Provide timely feedback, written and/or verbal reinforcement, and regular staff and/or one-on-one meetings
• Develop and achieve departmental goals and objectives; develop and work towards departmental and organizational dashboards
• Monitor payroll to ensure adherence to payroll policies
• Perform random chart reviews to ensure timeliness of Case Management activities
• Monitor documentation in the software platforms for appropriate use
• Work closely with the Chief Medical Officer as appropriate to ensure the timely resolution of issues
• Ensure that quality Care Management processes are provided to patients.
• Maintain data and metrics to submit to the Revenue Cycle Committee
• Report and develop timely reports to submit to the Utilization Management Committee as directed by the CMO
• Review UR plans annually, revising as necessary, and submit to the Chief Medical Officer for approval by the Utilization Committee and Medical Executive Committee
• Develop and maintain department budgets and ensure that the department operates within the allocated funds
• Monitor monthly expenses and variances and recommend adjustments for future budget periods

• Oversee and coordinate the Case Management program’s development to include the hospital resources as necessary to support its success
• Collaborate with Nursing and other departments to expedite patient throughput/LOS
• Collaborate with Directors, Unit Directors, Physicians, and other staff to implement changes that will improve the quality of care and patient satisfaction
• Facilitate and foster staff and MD participation in the development and/or process improvement activities and events that improve the care coordination process
• Communicate Case Management results through appropriate committees
• Develop and implement a continuous process improvement plan

• Maintain a positive work environment for employees within the department
• Provide Human Resource support and guidance to department employees as needed

• Assess and identify staff education needs, and create and participate in staff education opportunities as required

Supervisory Responsibilities

Reports to: Chief Medical Officer

Supervises: Case Management staff including Care Managers and Social Workers, Bundles Navigator and Hope program staff

Responsibilities: Maintaining the Case Management, Patient Improvement, and Patient Safety departments, as well as their corresponding capital and operating budgets

Education and Experience

Minimum Required Education: Master of Science in Nursing or related field or ability to obtain within 2 years of hire. Registered Nurse license required.

Experience: 5 years in an acute care case management department and 2 years management experience within an acute care facility.

Certificates, Licenses, Registrations

Registered Nurse

CCM or ACM within 2 years of eligibility