ADVANCED Professionals Inc.
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Executive Search Division, FL, United States
Director, Case Management & Social Services
Case Management Director-VP
Van Nuys, CA, United States
# of Beds:
EXPERIENCE/QUALIFICATIONS: Five (5) to ten (10) years of progressive experience in nursing leadership and case management required. Strong clinical background, experience in care coordination, discharge planning and overall case management experience required. Possess knowledge of payer requirements and discharge planning regulations that support the effect development of departmental policies, procedures and standards. Demonstrates ability to: Establish the goals, vision, and overall direction of a department; create and implement departmental standards, systems, staffing plan and processes; analyze issues and create an effective plan to address them; Critically and comprehensively evaluate the department’s outcomes; Identify, collect and analyze data related to the internal and external environment as well as departmental functioning. Demonstrates ability to communicate verbally and in writing to internal and external constituencies. Exhibits ability to establish priorities, meet deadlines, and develop and manage the departments’ productivity standard in the management of work assignments. Exhibits ability to form positive, collaborative relationships with members of the medical staff, hospital staff and post-acute providers and payers. Exhibits ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge. Exhibits ability to effectively negotiate with internal and external service providers. Possess knowledge of external requirements that impact the department, i.e., DNV and California Department of Public Health. Demonstrates proficiency of Interqual to support the evaluation and decision process used to determine the appropriate level of care. Demonstrates case management experience in a risk contracting environment strongly preferred. Possess knowledge of reimbursement and payment methodologies of managed care and medical population. Demonstrates knowledge of basic Microsoft computer skills. EDUCATION: Baccalaureate degree in Nursing required; Master’s Degree in Nursing or related field preferred. LICENSURES/CERTIFICATION: Current licensure with the California Board of Registered Nursing Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment
The Director of Case Management will be responsible for the strategic development and overall operations of Case Management functions to drive clinical, fiscal and compliance outcomes. Develop effective and efficient systems and processes for care / utilization management, discharge planning / transition management, and coordination of care. Oversees the collection, analysis, and reporting of data related to care management processes, utilization management and length of stay. Accountable for achieving established performance targets through actively engaging multiple disciplines, professional staff and departments. Appropriately manages people, relationships and process to optimize results. Engages internal and external stakeholders in care management processes; promotes interdisciplinary collaboration; fosters teamwork; and champions service excellence.