Director, RN Case Management, Inpatient Utilization Mgmt, Full-Time, Days (8hrs)
MemorialCare Health System
Location: Long Beach, California
Internal Number: LON008423
The Director of Case Management oversees the day to day operations related to utilization management, utilization review, case management, discharge planning, including:
Encouraging the appropriate and timely use of resources on the individual patient level and through participation in the Care Lines and Medical Staff Committees.
Provides safe and efficient movement of patients through the continuum of care
Management of LOS per financial targets
Liaison for major medical groups
Obtaining authorization for payment through medical necessity review
The Director of Case Management is responsible and accountable for the implementation of the case management program. The components/roles of the case management program consist of the following: care progression, utilization management, discharge planning, social services, and resource utilization. The Director is responsible for developing systems and processes for case management and discharge planning at the acute care hospital level. The Director evaluates and ensures that hospital resources are used appropriately and effectively. The Director oversees the collection, analysis, and reporting of financial and quality data related to utilization management.