Enterprise Solutions, Inc.
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https://www.enterprisesolutioninc.com
https://www.enterprisesolutioninc.com
USD
141128
176404
YEAR
true
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
Administrative Director of Care Management
Houston, TX 77082 United States
Posted: 02/23/2024
2024-02-23
2024-07-28
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
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