Enterprise Solutions Inc

Career

Administrative Director of Care Management

Houston, TX 77001

Posted: 02/23/2024 Industry: Healthcare - Health Services Job Number: z5G7h3l6a1kMvyS65NP3c6-2Si4VKxjssryAlGpwWhQ= Pay Rate: 141128-176404 Yearly USD

Job Description


Education: Bachelor of Nursing (BSN) or Masters Social Work (MSW). Master’s degree preferred

Licenses/Certifications:

Current and valid license to practice as a Registered Nurse in the state of Texas or

Current and valid Texas license as a Master’s Social Worker (LMSW) required,

LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM) or

Fellowship of the American Academy of Case Management (FAACM) required .

Must-Haves:

LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM) or

Fellowship of the American Academy of Case Management (FAACM) required

Current and valid license to practice as a Registered Nurse in the state of Texas or Current and valid Texas license as a Master’s Social Worker (LMSW) required,

Minimum five (5) years’ experience in utilization management, case management, discharge planning or other cost/quality management program

Three (3) years of experience in hospital-based nursing or social work preferred

Minimum five years’ experience in utilization management, case management, discharge

planning or other cost quality management program

Three years of experience in hospital-based nursing or social work preferred.

Job Description

The Director of Care Management is responsible and accountable to work with the Directors of Case Management on the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning.

The Director is responsible for overseeing/suggesting the development of systems and processes for care/utilization management at the local level. In addition, the Director is responsible for monitoring the progress of hospital department activities related to discharge planning and clinical quality improvement. The Director works with the local level Directors on matters that impact resource utilization and promotes the effective and appropriate use of hospital resources. The Director supports the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement. The Director promotes interdisciplinary collaboration, fosters teamwork and champions service excellence.

Experience/ Knowledge/ Skills:

Minimum five (5) years’ experience in utilization management, case management, discharge planning or other cost/quality management program

Three (3) years of experience in hospital-based nursing or social work preferred

Knowledge of leading practice in clinical care and payor requirements

Self-motivated, proven communication skills, assertive

Background in business planning, and targeted outcomes

Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management

Working knowledge of the concepts associated with Performance Improvement

Demonstrated effective working relationship with physicians

Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes

Effective oral and written communication skills

Meet Your Recruiter

Apply Online

Send an email reminder to:

Share This Job:

Related Jobs:

Login to save this search and get notified of similar positions.