Registered Nurse Case Management Services Director

RN Case Management Services Director

This position is responsible for the development and implementation of case and utilization management programs and services. This position provides leadership, direction and support for Care Coordination Services in the pursuit of best practice to achieve quality outcomes, reduce costs, and shape and interpret the standards required to ensure a high degree of patient, physician and employee satisfaction. This position will also have responsibilities for multiple facility/entity-specific patient outcomes related to patient goals, contractual deliverables, and/or connections with post-acute services.

Additional Information:

Direct reporting structure to Case Management Sr. Director with matrix reporting to facility CMO. Must possess current (Basic Life Support) BLS certification with annual renewal. Will require travel between facilities including additional facility responsibilities as required. No company cell phone provided. Will be required to take on-call rotation with other leaders and for other facilities. Requires a Bachelors of Science in Nursing or Masters of Science in Nursing. Must have 3 years acute experience with age specific patient population in the area of responsibility and minimally 3 years of progressive leadership experience. Must possess demonstrated flexibility in responding to the needs of multiple constituencies with a service-oriented philosophy. Must also possess demonstrated skill in problem analysis, project management, contract negotiation, conflict resolution and oral/written presentation. Requires strong working knowledge of utilization management, care management, regulatory standards and reimbursement across the continuum of care.

Preferred Qualifications:

Managed care experience preferred; CCM (Certified Case Manager) preferred. Additional related education and/or experience preferred.

Physical Demands/Environmental Factors:

As outlined per the job description - Typical Direct Patient Care environment: (Nutrition Rep, Chaplain, RN) * Able to stand, walk, bend, squat, reach, and stretch frequently. * Possess physical agility and adequate reaction time to respond quickly and appropriately to unexpected patient care needs. * Needs adequate hearing and visual acuity, including adequate color vision. * Requires fine motor skills, adequate eye-hand coordination, and ability to grasp and handle objects. * Able to use proper body mechanics to assist patients in ambulating, transferring in and out of bed, chair or wheelchair. * May be required to lift up to 75 pounds. * Must use standard precautions due to threat of exposure to blood and bodily fluids. * Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone. * May require periodic use of personal computer.

Can you answer these questions:

Health-care consumerism is a strategic focus within Banner. Can you describe how case management positively or negatively impacts patient experiences within the acute care setting? How you would lead your department to improve patient experience scores? Can you describe a length of management strategy you have used as a leader to positively improve the length of stay reduction?

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About Banner Health Corporate

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.

About Banner Health

Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to change the way care is provided. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

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Job Summary

This position is responsible for the development and implementation of case and utilization management programs and services. This position provides leadership, direction and support for Case Management Services in the pursuit for best practice to achieve quality outcomes, reduce costs, and shape and interpret the standards required to ensure a high degree of patient, physician and employee satisfaction. This position may also have responsibilities for other facility/entity-specific patient outcomes.

Essential Functions

* Plans, directs and monitors the case and utilization management program(s). Provides advice, counsel, feedback and coordination to promote a collegiality between staff, physicians and the leadership team.

* Ensures that development of case management services across the continuum leads to outcomes supportive of the organizations strategic plan. Designs and implements processes to ensure appropriate care coordination in accordance with regulatory and standards of safety.

* Provides direction for multidisciplinary process improvement activities, including the establishment of performance measures to attain optimal clinical, operational, financial and satisfaction outcomes. Directs the collection, analysis and presentation of data on utilization patterns and other program outcomes.

* Directs personnel actions including recruiting, new hire actions, interviewing and selection of new staff, salary determinations, training, and personnel evaluations. This position also participates in the development of Case Management goals and objectives in accordance with company standards.

* Manages the financial and capital resources for case management services by monitoring operating revenue and expenses, establishing and maintaining cost control programs and developing and implementing new or revised programs and/or services. Develops and implements strategies to work with all external customers to ensure appropriate reimbursement.

* Develops and oversees the department budget in conjunction with corporate goals and objectives. This position is accountable for meeting annual budgetary goals.

* Assesses patient satisfaction in areas of responsibility; sets a high standard for staff and leadership to improve patient satisfaction as measured by survey scores.

Minimum Qualifications

BSN or MSN required for all new hires to the position after October 1, 2016. Incumbents in the position prior to October 1, 2016 must possess a bachelors degree in a related field.

Requires a current Registered Nurse (R.N.) license in state worked. In an ambulatory setting, a CCM (Certified Case Mgr) must be obtained within 3 years of accepting position.

Must have considerable experience with appropriate age specific patient population in the area of responsibility as typically demonstrated through at least 2 years of management experience and two years of providing direct, clinical care in a patient setting.

Must possess demonstrated flexibility in responding to the needs of multiple constituencies with a service-oriented philosophy. Must also possess demonstrated skill in problem analysis, project management, contract negotiation, conflict resolution and oral/written presentation. Requires strong working knowledge of utilization management, care management, regulatory standards and reimbursement across the continuum of care.

Preferred Qualifications

Masters degree in nursing or business is preferred; Managed care experience is a plus; CCM (Certified Case Mgr).

Additional related education and/or experience preferred.