Come and grow your career with Kindred Hospitals, a division of Kindred Healthcare. Our culture of caring for our patients and residents begin with our core values – our employees. We are committed to fostering professional growth and dedicated healthcare teams that make us the provider of choice. We embrace a diverse workforce and understand that hiring outstanding people is the key to providing quality care – and quality care is what we do every day! Join us!
As a Director of Case Management, you will: • Responsible for case management, utilization review, discharge planning, and social services, as well as annual plans and budgets. • Handle the financial resources of the patient and family, by coordinating the delivery of quality service. • Manage relationships with the payers, physicians, hospital referral sources, and your case management staff. • Help facilitate the discharge-planning process, and serve as an advocate for the patient and family. • Work to ensure financial reimbursement of every individual case.
Job Responsibilities: • Develop and implement the philosophies, policies, procedures and goals for the Case Management Department. • Train and develop the Case Management staff and motivate them to accomplish department goals and objectives. • Develop and oversee the annual Case Management budget. • Prepare and evaluate monthly, quarterly and annual reports of the Department’s functions. • Provide information regarding changes in Medicare regulations and documentation issues to physicians and others as needed. • Maintain Prospective Payment System, monthly case log and other files needed for peer review organization and specific needs of the hospital. • Analyze physician utilization patterns, comparing to national and individual hospital standards. Communicate findings to Utilization Review and other appropriate individuals. • Discuss denial of coverage related to Utilization Review with the Director of Quality Management. Assist with on-site monitoring reviews by PRO, Blue Cross, outside review organizations and third-party payers. • Maintain a working relationship with local, state and federal agencies, recognizing the hospital’s position in the community and its need for cooperation and assistance from such services.
Qualifications: • Bachelor’s degree in clinical area required. Bachelor of Science in Nursing preferred. Equivalent combination of education, training, and experience may substitute for education requirements. • Current healthcare professional licensure as Registered Nurse, Respiratory Therapist, Physical Therapist, Occupational Therapist or Social Worker required. • Appropriate certification in Case Management preferred for example, Commission for Case Manager Certification (CCMC) Association of Rehabilitation Nurses (ARN) certification. • Minimum three years’ experience in Hospital Case Management • Should be knowledgeable in TQM/QI and have recent experience as a Case Manager in insurance, workers compensation or medical management.