Case Management Director, RN

Responsibilities include: Performs daily case management, discharge planning, and utilization review duties while fulfilling departmental leadership responsibilities. Provides direct case management coverage as needed to support patient needs, staffing levels, and continuity of services. Oversees the programs, operations, and staff within Case Management, Social Services, Discharge Planning, Project RED, Transitional Care Management, and Utilization Review. Establishes clear performance expectations, models those expectations through daily practice, and holds direct reports accountable. Coordinates continuous process and quality improvement within assigned areas. Promotes a positive, collaborative teamwork environment. Serves as a patient advocate, investigates and reports adverse occurrences, and provides staff education related to areas of responsibility. Promotes effective and efficient utilization of clinical resources. Facilitates interdisciplinary rounds and care conferences to review treatment goals, optimize resource utilization, provide patient and family education, and identify post-discharge needs. Collaborates with physicians, nursing, and other clinical staff to develop and implement individualized plans of care, address barriers, and facilitate timely testing, treatment, and discharge. Performs and oversees utilization reviews from admission through discharge to support appropriate admission status, medical necessity, and efficient use of services. Assesses patient needs throughout the continuum of care, considering diagnoses, procedures, and diagnosis-related groups (DRGs).Communicates regularly with physicians throughout hospitalization and maintains effective working relationships. Provides staff education, coaching, and feedback to support appropriate utilization, cost management, documentation, and patient outcomes. Supervises and audits Case Management and Social Services documentation, providing education and follow-up as needed. Directs and participates in the development and implementation of evidence-based policies and procedures. Oversees Social Services staff and assists with coordinating support for patients, families, and significant others as they manage the impact of illness and post-discharge needs. Attends assigned meetings and participates in projects in a timely, positive, and collaborative manner. EDUCATION AND/OR EXPERIENCEAssociate degree in nursing from an accredited college or university required. Bachelor’s degree preferred, or willingness to obtain. Current Kansas Registered Nurse license required. Minimum of three years of acute care nursing experience and three years of Case Management and Utilization Review experience required. Must demonstrate knowledge of acute care treatment, care coordination, discharge planning, and utilization review processes. Previous leadership experience required. Computer literacy required; recent proficiency with word processing and spreadsheet applications preferred.