Responsible for day-to-day oversight and coordination of case management and discharge planning functions to ensure patient care quality and efficiency, while complying with regulatory requirements.
Collaborates with multi-disciplinary teams to optimize patient flow and demonstrates critical thinking and effective communication skills. Must work independently in stressful environments and take appropriate actions.
Requires knowledge of State and Federal discharge regulations, hospital information systems, staff development techniques, and performance improvement processes. Proficiency with Interqual or Milliman guidelines is essential.
Qualifications include a minimum of 3 years of case management experience and 2 years of leadership in similar roles, with a background in clinical decision-making, medical criteria, and discharge planning. A nursing degree or BSN is required, with case management certification preferred.