Responsibilities:  

　　Case Management Director oversees a staff of case managers responsible for patient care coordination.

　　Develops and implements case management programs, including preventive measures, CCIP initiatives and any other as necessary.

　　Staff management including recruitment, identification, hiring, orientation and supervision for Clinical Care Management, Non-Clinical Care Management, and Care Coordinator  staff.

　　Case Management Director evaluates patient care data to ensure that care is provided in accordance with clinical guidelines and organizational standards.

　　Seeks treatments that balance clinical and financial concerns with the family's needs and the patient's quality of life.

　　Additionally, Case Management Director contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care.

　　Provides input to strategic decisions that affect the functional area of responsibility.

　　Develops, implements, and updates policy and procedures as  necessary.

　　Conducts SNP/interdisciplinary care team  meetings.

　　Responsible for resolve escalated issues arising from operations and requiring coordination with other  departments.

　　The director ensures staff compliance with organizational policies and external regulatory agencies and takes leadership responsibility to coordinate the integration of department's patient care and processes to ensure continuity of care and optimal clinical resource utilization.

　　Oversees department/program evaluation and  reporting.

　　Ensure appropriate utilization of resources, facilities and services by reviewing any services needed or rendered for SNP members.

　　Develop and implement programs / activities to optimize patient outcomes.

　　Provide departmental needs assessment identify goals, develop and implement ac ion plans in order to achieve objectives.

　　Oversees the department staff Effectively manage all SNP member needs and collaboration with care team members to prevent unplanned transitions and readmissions via interventions.

　　Qualifications:

　　Ability to read, analyze and interpret general business periodicals, professional journal, technical procedures or governmental regulations.

　　Minimum of three (3) years of supervisory or management level experience in managed care is preferred. Medical staff services, health services or government assistance programs; or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities to perform the job duties will be considered on an individual basis.

　　Medicare Case Management Program especially with Special Needs Population is preferred.

　　Fluent in English and Spanish, preferred but not required.

　　Excellent presentation and organizational skills.

　　Note:  This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s).  Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.   

　　No Third Party Agencies or Submissions Will Be Accepted.   

　　Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP   

　　Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.

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