Nurse Director Case Management Overview • Lead and oversee the Case Management team, ensuring efficient utilization management and discharge planning processes. • Collaborate with multidisciplinary teams to enhance patient care coordination and outcomes. • Develop and implement strategies to reduce readmissions and improve patient satisfaction. • Ensure compliance with healthcare regulations and standards, maintaining high-quality care delivery. • Provide leadership and supervision to case managers, social workers, and clinical coordinators. • Utilize continuous quality improvement tools to assess and enhance service delivery. • Foster a collaborative and fast-paced work environment focused on positive patient outcomes. • Support staff development through training programs and professional growth opportunities. Nurse Director Case Management Key Responsibilities & Duties • Oversee all aspects of utilization management, discharge planning, and care coordination. • Develop and maintain systems for effective operation of the Case Management Program. • Assess patient needs and design services aligned with hospital mission and family requirements. • Supervise and mentor case managers, social workers, and discharge planners. • Ensure compliance with Milliman and InterQual Criteria for patient care standards. • Utilize analytical skills to evaluate data and improve case management processes. • Collaborate with healthcare teams to streamline patient transitions and reduce readmissions. • Implement training programs to enhance staff competencies and performance. Nurse Director Case Management Job Requirements • Bachelor of Science in Nursing (BSN) required; active CA Registered Nurse license mandatory. • Minimum 5 years of experience in a Case Management position; 7 years preferred. • Knowledge of Milliman and InterQual Criteria preferred; BCLS certification is advantageous. • Proficiency in basic to intermediate computer skills and analytical problem-solving capabilities. • Demonstrated leadership ability in a collaborative healthcare setting. • Strong communication and organizational skills to manage multidisciplinary teams effectively. • Commitment to continuous quality improvement and patient-centered care delivery. • Experience in developing and implementing case management strategies and systems.