Director Of Case Management
Company: Avem Health Partners
Location: Oklahoma City
Posted on: January 23, 2023
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Job Description:
*JOB PURPOSE: *The Director of Case Management is responsible
for the development of staff and systems to effectively operate a
comprehensive Case Management Program. Provides leadership and
consultation to case managers, social workers and case management
coordinators. Assesses needs and plans, communicates and designs
services that are appropriate to the hospital mission and
patient/family needs. Integrates and coordinates services using
continuous quality improvement tools.*ESSENTIAL FUNCTIONS INCLUDE
BUT NOT LIMITED TO: ** Researches and identifies relevant industry
standards. Updates job knowledge by studying trends and
developments in case management.* Collaborates with executive
management, establishes benchmarks that are attainable but exceed
industry standards.* Introduce solutions to minimize denials,
accommodate higher patient volumes and strengthen overall quality
metrics.* Enhances clinical and financial outcomes through
performance improvement activities.* Assists facility Case
Management departments in regulatory compliance.* Directs and
evaluates all services provided, including care plan development,
service level determination, and complaint management to achieve
performance and quality control objectives.* Provides specialized
expertise, ensures resource alignment with system-wide initiatives,
and updates appropriate parties on initiatives, outcomes and
issues.* Performs under minimal supervision with accountability for
specific goals and objectives.* Identifies and resolves problems.*
Demonstrates problem solving, leadership, conflict management and
team building skills in order to ensure a productive work
environment and achievement of goals.* Enhances department and
organization reputation by accepting ownership for accomplishing
new and different requests; explores opportunities to add value to
job accomplishments.* Oversees internal audits to ensure
consistency and compliance with organizational standards, clinical
pathways, and external requirements.* Evaluates clinical
documentation with regard to medical necessity, appropriate use of
clinical pathways, evidence-based care, and efficiency of care.*
Ensures compliance in all risk management matters for Company's
various lines of business, including all state, federal, and
regulatory body requirements.* Other duties as assigned within
scope of practice.*BEHAVIORAL STANDARDS** The individual must
support the mission, vision, and goals of Avem Health Partners and
serve as a role model within the company.* Exhibit positive
customer service behavior in every day work interactions.*
Demonstrate a courteous and respectful attitude to internal
workforce and external customers.* Communicate accurately and
appropriately.* Handle difficult situations in a discreet and
professional manner.* Hold self-accountable for professional
practice.* Participate in performance improvement activities
utilizing principles to support and improve departmental goals.*
Demonstrate knowledge of unit goals and is active in committees and
projects to achieve these goals.* Keep current with literature
regarding changing practices, interventions and best practices.*
Assume responsibility for seeking out educational and professional
opportunities for personal learning needs and growth as well as
meeting mandatory education requirements.* Act as a preceptor as
requested.* Demonstrate excellent work attendance and actively
participate in a variety of meetings and training sessions as
required.* Adhere to the Avem Health Partners Code of Conduct and
Standards of Behavior. Complies with established policies and
procedures and all health and safety
requirements.*EDUCATION/QUALIFICATIONS: ** Graduate of an
accredited school of nursing, BSN preferred.* Current Oklahoma RN
license, current BLS.* Five (5) years' experience required.* Two
(2) years of leadership or management experience required.*
Understanding of the unique needs associated with various age
populations and the ability to provide age specific care and
services.* Must possess the knowledge and skills necessary to
effectively meet the needs of the patient/internal & external
customer.* Knowledgeable about Medicare, Medicaid, and other third
party payers.* Knowledgeable about local, state, federal and
community resources and the scope of services they provide.* Direct
experience with regulatory agencies and third party payers within
the last two years.* Experience in discharge planning and a working
knowledge of alternative delivery systems including home health,
durable medical equipment, rehabilitation, extended care facility
and skilled nursing facilities, their scope of services and their
criteria for care.* Consistently demonstrates a professional,
self-directed, mature, disciplined and tactful approach to position
responsibilities.* Practices good guest relations with patients,
visitors, physicians and staff, assists as needed.* Intermediate
computer skills.*CERTIFICATION/LICENSURE: ** Current Oklahoma RN
license* Current BLS (or obtained within 30 days of hire)*
Certified Case Manager (CCM) preferred* Valid driver's
license*PHYSICAL REQUIREMENTS: ** To perform this job successfully,
an individual must be able to perform each essential job duties
satisfactorily. The requirements listed are representative of the
knowledge, skill, and/or ability required. Reasonable accommodation
may be made to enable individuals with disabilities to perform the
essential functions. Such accommodations must be requested by the
employee/applicant to be considered.* This job requires visual
abilities, auditory abilities, must be intact to perform
duties.#INDHPJob Type: Full-timeBenefits:* 401(k)* 401(k) matching*
Dental insurance* Disability insurance* Flexible spending account*
Health insurance* Life insurance* Paid time off* Vision
insuranceSchedule:* 8 hour shift* Monday to FridayAbility to
commute/relocate:* Oklahoma City, OK 73134: Reliably commute or
planning to relocate before starting work (Preferred)Education:*
Bachelor's (Preferred)Experience:* Case management: 5 years
(Required)* supervisory: 2 years (Required)License/Certification:*
Driver's License (Preferred)* Oklahoma RN License (Preferred)* BLS
Certification (Preferred)* Certified Case Manager (CCM)
(Preferred)Work Location: One location
Keywords: Avem Health Partners, Oklahoma City , Director Of Case Management, Executive , Oklahoma City, Oklahoma
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