Job description
Overview:
Join our Hillcrest South team as a Director of Case Management!
Hillcrest HealthCare System (HHS) is a comprehensive health system providing quality healthcare in northeastern Oklahoma, with the system’s flagship hospital, Hillcrest Medical Center, located in Tulsa. Additionally, HHS is comprised of Bailey Medical Center, Hillcrest Hospital Claremore, Hillcrest Hospital Cushing, Hillcrest Hospital Henryetta, Hillcrest Hospital Pryor, Hillcrest Hospital South, Tulsa Spine & Specialty Hospital, Oklahoma Heart Institute and Utica Park Clinic. HHS has 1,180 licensed beds and an expansive network of clinics.
POSITION SUMMARY
The Director of Case Management, under the direction of the Chief Financial Officer, serves as an interdisciplinary team member to coordinate the delivery of health care services leading to quality outcomes for the hospital population and their families within the limits of the financial and social resources available. Responsibilities:
Join our Hillcrest South team as a Director of Case Management!
Hillcrest HealthCare System (HHS) is a comprehensive health system providing quality healthcare in northeastern Oklahoma, with the system’s flagship hospital, Hillcrest Medical Center, located in Tulsa. Additionally, HHS is comprised of Bailey Medical Center, Hillcrest Hospital Claremore, Hillcrest Hospital Cushing, Hillcrest Hospital Henryetta, Hillcrest Hospital Pryor, Hillcrest Hospital South, Tulsa Spine & Specialty Hospital, Oklahoma Heart Institute and Utica Park Clinic. HHS has 1,180 licensed beds and an expansive network of clinics.
POSITION SUMMARY
The Director of Case Management, under the direction of the Chief Financial Officer, serves as an interdisciplinary team member to coordinate the delivery of health care services leading to quality outcomes for the hospital population and their families within the limits of the financial and social resources available.
- Supervises Case Managers and Social Workers.
- Contributes to hiring and termination decisions, develops job descriptions and performance standards, schedules and monitors assignments and controls staffing levels to meet budgetary guidelines.
- Contributes to the development of a goal directed discharge plan of care that is prioritized and based on determined medical diagnosis, problems and expected patient outcomes.
- Acts as a liaison between business office and Nursing regarding payer issues, denials and prior authorization.
- Provides information to hospital employees and medical staff regarding case management, utilization review, and appropriate documentation for admission and continued stay criteria and DRG assignment.
- Communicates information as indicated.
- Monitors changes in community resources to assist patients and family as needed.
- Ensures that Case Management receives timely information.
- Keeps current on the development of case management systems on a national level and recommends changes as needed to maintain a state-of-the-art concurrent case management system.
- Contributes at a high level for hospital throughput discussions, decisions and reporting.
- Responsible for corporate audits as assigned.
Education and Experience:
- Bachelor's Degree in Nursing (BSN), Required.
- Master's Degree preferred.
- Minimum of 5 years of acute clinical experience
- Minimum of 3 years Clinical Case Management/Utilization Review experience preferred
License / Certifications:
- Current and valid Nursing License (RN) with the State of Oklahoma or OK compact license.
- Case Management Certification is high preferred. Must be willing to achieve case management certification within 12 months of hire if not already obtained.
Knowledge, Skill and Abilities:
- Ability to interact with a wide variety of individuals and handle several complex situations simultaneously.
- Maintains adequate physical and mental health to meet job performance standards.
- Theoretical knowledge of the nursing process, case management and continuity of care.
- Advanced assessment and teaching skills.
- Motivation for self-direction, integrity and initiative.
- Attention to detail and follow-up.
- Speaks and reads English fluently.
- Ability to exercise supervisory skills and demonstrate leadership.
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