RN / Case Management Job in Las Vegas, Nevada / Home Health Care
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Description
Standard Qualifications: POSITION SUMMARY: The Director of Case Management coordinates all case management and social service activities for the hospital. The Director is responsible for ensuring that physicians' orders regarding transfers, home health care, durable medical equipment and the specific discharge needs of patients are being met. The Director will ensure that discharge planning is done to place patients in the most appropriate setting upon discharge. He/she will monitor the utilization of resources and work with the physicians, staff, and insurance companies to maximize quality and efficiency. The Director provides leadership and training to his/her staff to ensure that the staff understands and properly executes their specific responsibilities. He/she will work with physicians, administration and staff members to resolve difficult cases. He/she will coordinate with the medical director on performance improvement projects for the department. KEY ACCOUNTABILITIES: Case Management Program Administration: 1. Facility development of Hospital Case Management Program and Utilization Plan 2. Develops, implements, monitors, evaluates, and revises policies and processes to achieve the facility and department strategic plan, in accordance with regulatory, legal, administrative and corporate requirements. 3. Directs operation of the case management program including budget development and monitoring 4. Provides direction to Administration and the Medical Staff in the identification and analysis of case management issues affecting the clinical, legal and financial operations of the facility 5. Works collaboratively with other HCA Case Management entities in order to maximize effectiveness of department 6. Maintains ongoing communication with Hospital Leadership regarding case management issues 7. Maintains ongoing performance assessment process to identify current education needs for Case Management staff 8. Develops and implements educational programs for employees, medical staff and board members regarding functions of case management Discharge Planning: 1. Acts as internal consultant to all clinical areas in assuring adequate discharge planning resources 2. Provides leadership and supports to staff regarding all aspects of discharge planning, including appropriate allocation hospital resources, consideration of patient risk factors, negotiation with patients and families, fiscal intermediaries, regulatory agencies, external healthcare resources, and public agencies, 3. Appropriately resolves complex discharge planning-related issues 4. Participates, at the direction Administration, in community initiatives Utilization Management: 1. Collaborates with Internal & External Physician Advisors and medical staff to ensure quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. 2. Performs data analysis related to Case Management metrics 3. Develops, implements, and monitors case management action plans based on case management opportunities. Department: 1. Actively participates in strategic planning process for assigned department(s), considering existing service and unmet community and organizational needs. 2. Maintains a supportive work environment for staff through orientation, performance management, annual staff development and education plans. 3. Establishes, maintains and upgrades standards for staff competence as demonstrated by department(s) performance criteria. 4. Maintains knowledge of current trends and developments in the field by reading journals, books or other literature and attending related seminars and conferences. 5. Plans and conducts regular department meetings to keep staff informed of current department and system information and policies and to discuss pertinent issues. Provides minutes of the department meetings to staff 6. Coaches, counsel's staff as appropriate in accordance with HR policy. #LI-FW ~Nursecom~ 7
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