Director of Case Management - RN tciye8p5gdnj - Metro Associates

Employment Type: Full-time
Relocation Assistance Available: Partial; $5,000 stipend for eligible candidates
Bonus: Negotiable signing bonus
Job ID: tciye8p5gdnj

Our Award-Winning Client is currently seeking an experienced Director of Case Management for their Henderson, NC, facility. As a recognized leader in the healthcare industry, our client operates nationally and has received numerous accolades for excellence in patient care and safety. This position will oversee a diverse team responsible for key areas such as case management, concurrent coding, utilization review, financial outcomes management, social work, and patient education.

Key Responsibilities:

• Leadership & Management: Spearheads the Case Management team, ensuring the seamless integration of departmental functions with the broader goals of the organization. Provides daily clinical leadership, particularly to Patient Care Coordinators and Social Workers, while fostering an environment conducive to professional growth.
• Strategic Planning: Develops and implements departmental goals, plans, and standards in alignment with the organization's clinical, administrative, legal, and ethical objectives. Collaborates with Quality Management and Nursing Directors to drive positive clinical outcomes.
• Operations Oversight: Directs departmental operations, including patient care delivery, information technology, service level management, and complaint resolution, ensuring compliance with performance and quality control standards.
• Financial Stewardship: Prepares, monitors, and evaluates departmental budgets, coordinating internal and external audits to ensure fiscal responsibility. Reviews case mix, length of stay (LOS), and Diagnosis-Related Group (DRG) coding regularly, applying insights to identify improvement opportunities.
• Compliance & Quality Assurance: Ensures services and care provided in acute care settings meet medical necessity, appropriateness, and professional standards. Issues Hospital Notice of Non-Coverage as per hospital policy and participates in hospital and departmental safety programs.
• Staffing & Development: Oversees staffing activities, including hiring, orientation, evaluation, disciplinary actions, and ongoing education. Encourages the integration of evidence-based practices into operations and clinical protocols.
• Physician Collaboration: Works closely with individual physicians to address utilization review concerns, provides feedback on clinical and administrative data to aid in objective assessment of care patterns, and utilizes physician practice data to influence clinical and financial outcomes.
• Performance Improvement: Participates in performance improvement initiatives, collects data, and identifies opportunities for enhancement. Prepares quarterly reports for variance trending and action plans.
• Education & Communication: Educates medical staff on the Case Management program's importance, particularly in timely and meaningful documentation, and serves as a resource for Medical Advanced Beneficiary Notice issues.

Candidate Qualifications:

• Education: Bachelor's degree in Nursing is required, with a preference for candidates holding a Master’s degree or equivalent experience and education.
• Licensure: A current North Carolina or compact state Registered Nurse (RN) license is mandatory upon hire. Basic Life Support (BLS) certification through the American Heart Association (AHA) is also required at the time of hire.
• Experience: A minimum of three years in nursing case management is essential. Candidates with prior director or supervisory experience are strongly preferred.
• Skills: Critical thinking, decisive judgment, and the ability to work with minimal supervision are crucial for success in this role.

Benefits:

• Comprehensive health insurance options, including medical, dental, and vision coverage.
• 401K retirement plan with competitive matching contributions.
• Paid Time Off (PTO) programs, including PTO cash-out and donation options.
• Employee Assistance Program (EAP) offering support for mental, physical, and financial wellness.
• Loan Repayment and Tuition Reimbursement/Assistance for qualifying employees.
• A robust employee recognition and awards program.

Note: Resumes will be maintained in strict confidentiality until such time as we engage in a detailed discussion regarding a specific opportunity, and both parties mutually agree to proceed. We consistently receive new opportunities every day. Should your professional background closely align with the specific requirements of our client, we will promptly reach out to you to initiate further exploration of potential opportunities.