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Director of Case Management

Req #: 17012222
Location: Hendersonville, NC
Job Category: Case Management
Organization: Park Ridge Health

Description
Park Ridge Health
 

Park Ridge Health has provided whole-person care to the Henderson County community for more than 100 years. Inspired by our mission of Extending the Healing Ministry of Christ, we continually look for ways to bring hope, health and healing to the patients we have the honor of caring for.  As a member of Adventist Health System, one of the largest faith-based healthcare organizations in the U.S., we also offer world-class opportunities for our team members to learn, grow and serve across the nation.

 

Work Hours/Shifts

Full Time / Day
 
What you will responsible for:
 

Supervise Case Managers and Discharge Planners who follow patients from pre-admission through discharge to home, nursing/rehab facility or home care program. Assure appropriate discharge planning for the patient and family and comply with all regulatory and financial guidelines. Oversee utilization review, house supervisor and discharge planning.

  • Maintains and utilizes current knowledge of utilization review criteria and reimbursement guidelines to serve as a resource person for the Care Management Department. Acts as a resource for medical staff, interpreting requirements of federal, state and third-party payer guidelines for coverage.
  • Identifies potential for over and underutilization of hospital resources, non-acute and potentially avoidable days, takes appropriate interventions, trends and reports data.
  • Collaborates with nursing and other clinical staff to achieve optimal clinical outcomes.
  • Conducts multidisciplinary case conference to promote communication about patient status and future plans and to assure coordination of care.
  • Demonstrates appropriate clinical knowledge in order to assist physicians in providing complete documentation of severity of illness and intensity of services in order to assure that criteria for acute hospitalization are met. Acts as a liaison with physicians to assure that aspects of treatment are fully documented and to assist in identifying other options for care when acute hospitalization is no longer.

Qualifications
What you will need:
  • Master’s Degree in Nursing, MBA, MHA, MSN
  • At least 3 years of care management experience.
  • Current North Carolina state license as a Registered Nurse required.
  • Supervisory or leadership experience within care management in last 4 years preferred
  • Additional languages preferred

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
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