HCA, Hospital Corporation of America Director of Case Management in Gainesville, Florida
Coordinates hospital-wide case management functions including assessment, improvement activities, regulatory and accreditation surveys and compliance, appropriate admissions/status, and length of stay. Collects and reviews data from internal and external sources to evaluate the quality of case management functions in collaboration with the medical staff, departmental directors and hospital leadership. Retrieves, communicates, and presents information in a written auditory, visual fashion, as needed. Responsible for overall collaborative coordination, with leadership members, for hospital-wide case management activities, and coordination of care. Collaborates with department managers, senior leadership, and employees through assessment of patient learning needs and discharge planning, designing, implementing and evaluating case management activities.
Coordinates the collaborative case management process.
Assists with providing statistical data for Medical Staff Committees as requested, related to Utilization Review Management.
Prepares reports for committees in cooperation with the Chair of the URM committee.
Monitors qualitative/quantitative indicators per InterQual criteria, appropriateness of admissions and utilization of resources.
Analyses data for trends of improvement and/or areas of concern and recommends appropriate actions related to case management throughout the continuum of care.
Maintains mechanism to follow-up on areas of concern.
Reviews patient records as requested for QI issues.
Monitors for JCAHO, state and regulatory compliance related to Case management.
Designs methodology for tracking review of patients for criteria and authorizations.
Assists with daily self-pay flash meetings, as well as seeks resources available for the self-pay/indigent population, collaboratively with the CM’s and MD’s.
Coordinates and has oversight of primarily concurrent and retrospective review of records related to patient days.
Works cooperatively with Health Information Management Department’s procedure in requesting and returning records for discharge dispositions.
EDUCATION REQUIRED AND/OR PREFERRED: Graduate of an accredited school of nursing as an RN. BSN preferred. MSN, MBA or Master’s degree in related field preferred.
EXPERIENCE REQUIRED OR PREFERRED:
5 to 8 years related case management experience. Minimum of 3 years hospital acute care case management experience. Successful leadership/management experience within matrixed, corporate organizations.
SKILLS, KNOWLEDGE, AND ABILITIES: Demonstrated success and abilities in leadership, achieving results, communications, customer service and health care management. Demonstrates assertive and diplomatic communication skills with a leadership style that initiates engagement, collaboration and direction with clearly defined expectations. Demonstrated results in the implementation of length of stay reduction and accountable reporting through metrics.
LICENSURE/CERTIFICATION: RN license in the State of Florida. CCM Certification is preferred.
Title: Director of Case Management
Location: Florida-Gainesville-North Florida Regional Medical Center
Requisition ID: 00039-10340