Director, Care (Case) Management

• Oversees the overall operations of care management functions through oversight of both daily and long-term activities at the hospital. Is responsible for developing systems and processes for case management and social services, and managing department activities related to clinical quality improvement. Actively provides support and leadership to collaborative discharge planning and utilization review processes. Coordinates duties with appropriate personnel to meet operational program needs, ensures compliance with state and federal health plan requirements, Medicare guidelines and standards; develops and implements policy and procedures, updates and integrates current clinical practice guidelines.

• Supervisory principles and practices; nursing process (assessment, planning, implementation and coordination of patient care); standards of care; disease process of illnesses or injuries in variety of specialty areas; patient care plan development; patient evaluation and assessment technique discharge planning processes; Nurse Practice Act; third party reimbursement regulations and rules; department and hospital safety practices and procedures; patient rights; infection control policies and practices; handling, storage, use and disposal of hazardous materials; department and hospital emergency response policies and procedures; age specific patient care practices.

• Working with patients in a variety of conditions; supervising the work of assigned staff; interpreting rules and regulations; interpreting and analyzing patient medical charts; using computers and a variety of software applications; communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds under stressful conditions; establishing and maintaining effective working relationships with all personnel contacted in the course of duties; efficient, effective and safe use of equipment.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.

• Equivalent to a Bachelor's Degree in nursing, management, business administration or related field and five (5) years of clinical nursing experience, or utilization review/case management experience, three (3) years of which were in a supervisory/managerial role.
• Professional level experience is defined as being employed in an FLSA exempt/salaried status position.

• License from State of Nevada to Practice as a Registered Nurse. Basic Life Support (BLS) Certification.

• Master's Degree 
• Certified Case Manager (CCM)
• EPIC Knowledge

• Five (5) years of recent documented experience demonstrating progressive leadership with three (3) years specific to Case Management 
• Case Management in a large and complex acute care hospital environment 
• For-profit acute care case management leadership 

• Drives results based on key performance indicators
• Ability to problem-solve 
• Strong interpersonal skills to collaborate with Physicians, Executive Leadership, Colleagues, and Staff
• Ability to hold others accountable 

Last updated on Nov 2, 2023