Responsible for day-to-day oversight and coordination of case management and discharge planning functions, ensuring patient care meets quality and efficiency standards while complying with regulatory requirements.
This role requires understanding of payer guidelines and collaboration with multi-disciplinary teams to optimize patient flow. Key skills include critical thinking, effective communication (verbal and written), decisive judgment, and the ability to work independently in stressful environments.
Must possess knowledge of State and Federal regulations, hospital information systems, staff development, and performance improvement processes. Proficiency with Interqual or Milliman guidelines and process improvement and performance monitoring is essential.
Required experience includes a minimum of three years in case management and at least two years in leadership roles within case management. Education should include a nursing degree or BSN, with case management certification preferred.