RN Director of Case Management

General Summary of Position

Med Star Southern Maryland Hospital Center is looking for an RN Director of Case Management.

Our hospital center is leading the way by providing the highest quality clinical care with advanced technology, innovative medical services, and the region's top doctors. Our hospital center not only treats illnesses and injuries but also promotes wellness and community health.

We are a full-service acute care facility with more than 44,000 emergency room visits and nearly 11,000 admissions each year. Our hospital's commitment to advanced technology distinguishes it from community hospitals. Our goal is to help residents of Southern Maryland achieve the highest possible level of physical and mental health and thereby improve the quality of life in our community.

We strive to provide comprehensive inpatient, outpatient, and community services to residents of Southern Maryland.

We achieve quality, safety, wellness, and patient satisfaction through a spirit of patient-centered services that connect us to the community we serve.

Our Heart and Vascular Center's cardiac catheterization laboratories are the site of life-saving interventions for heart attack patients, elective angioplasties, and diagnostic procedures.

We have the Med Star Georgetown Cancer Institute (MGCI) at Med Star Southern Maryland Hospital Center, which has technology not available anywhere else in the area, such as Halcyon treatment system and Zap-X.

We have a Level II Special Care Nursery.

We have a strong neurosciences program, with Med Star Georgetown University Hospital neurologists and neurosurgeons available onsite.

The RN Director of Case Management will develop, implement and evaluate the strategic plan for the hospital-wide Case Management process. Provide operational supervision of case management department. Coordinate and support ongoing problem solving. Establish tools, processes, and systems to optimize the individual roles of the department.

Requirements:

• BSN Required, MSN Strongly Preferred
• Active Compact or MD RN license Required
• 5-7 years' experience in Case Management with 3-5 years' experience in Case Management Leadership Required
• 3-5 years' experience in acute care bedside nursing Required

• Responsible for assuring compliance with hospital wide patient care quality monitoring in collaboration with the Performance Improvement Department.
• Assures performance improvement activities with ongoing monitors for the Case Management Department.
• Knowledgeable of the organization's performance improvement priorities and outcomes.
• Assists the organization to achieve compliance in the Important Functions described in the Joint Commission.
• Provides for direct supervision of utilization management activities as mandated by State/Federal regulations.
• Assures utilization criteria and monitors are approved by Medical Staff as appropriate.
• Maintains the program to assure coordination of patient services and financial issues related to reimbursement for care provided with all Managed Care Companies and outside providers.
• Assist Utilization Management Committee Chairman to prepare for meetings and comply with regulatory requirements.
• Assures appeals system is maintained and will coordinate with the Business Office for maximum reimbursement.
• A member of the Hospital Ethics Committee, the Clinical Pathways Committee, Medical Records Committee and the Performance Improvement Committee.
• Implements changes and maintains systems for statistical reporting of Utilization Review activities and develops outcomes documentation and reporting as the Case Management program evolves.
• Maintains ongoing communication with staff on the nursing units to address concerns relative to Case Management issues.
• Responsible for ongoing education of medical staff, nursing, and other ancillary services effected by development of and changes to the Case Management program in keeping with the changing health care environment.
• Assures ongoing communication with key departments/providers to assure negotiation/facilitation of patient movement through the health care system.
• Provides daily ongoing supervision of Case Managers and the…