Director Registered Nurse (RN) - Case Management
MarinHealth Medical Center
Greenbrae, CA
5x8 hrs, Days
Referral Bonus

JOB SUMMARY:

Responsible for managing the Case Management Department, ensuring collaboration, research, development, implementation, revision and reporting of case management programs in conjunction with the Social Work Department which is responsible for the Emergency Room and Women’s, Infants and Children’s Departments. Creates opportunities and systems to ensure specific patient outcomes are achieved. Responsible for developing and achieving department goals, as well as promoting professional standards in accordance with hospital policy, State and Federal guidelines. Works with other Hospital departments including Health Information Management, Revenue Cycle, Nursing and Physicians to optimize care from both the clinical and administrative viewpoints. Collaborates with other hospital departments as well as outside agencies to ensure appropriate continuity of care.

JOB SPECIFICATIONS:

EDUCATION

Bachelor’s degree in Nursing, or related health care field, preferred
Masters degree in Health, Business Administration, or Nursing required

EXPERIENCE

Three years’ experience in an acute health care setting
Five years’ administrative experience in Case Management

PREREQUISITE SKILLS

Effectively manages all aspects of case management that include clinical, psychosocial, utilization management and discharge planning
Ability to supervise staff including staff evaluations, counseling and mentoring
Ability to work collaboratively with team members, hospital staff, patients and physicians
Ability to manage change through collaborative and leadership skills
Ability to facilitate processes with individuals and groups, especially with projects towards achieving improvement outcomes
Ability to develop and monitor operational, capital, and staffing budgets
Advanced computer knowledge with desktop productivity software, preferably MIDAS and CERMe included.
Demonstrates verbal and written communication skills.

LICENSE/REGISTRATION/CERTIFICATION:

Current and valid California Registered Nurse license
Current BLS as required by hospital policy
Case Management certification preferred

PRIMARY CUSTOMER SERVED (Age Specific Criteria):

(X) Adolescents 12 up to 18 years

(X) Early Adults 18 up to 45 years

(X) Middle Adults 45 up to 61 years

(X) Late Adults 61 up to 80 years

(X) Late, Late Adults 80 years and up

Employees in this position must be able to demonstrate the knowledge and skills necessary to provide care and/or service based on the physical, psycho/social, educational, safety, and related criteria appropriate to the age of the patients served in his/her assigned service area.

PATIENT PRIVACY (HIPAA Compliance):

Employees in this position have access to protected health information. The protected health information a person in this position can access includes demographics, date of service, insurance/billing, medical record summary information, and all other information that may be contained in patient records. This position requires patient health information to perform the functions outlined as part of this position description.

DUTIES AND RESPONSIBILITIES:

ESSENTIAL (not modifiable)

1. Manages overall case management activities within a managed care environment that include:

Clinical Management
Psychosocial Management
Utilization Management
Discharge Planning

2. Works with Physicians and other clinical staff to ensure appropriate coding, clinical documentation and compliance

3. Develops, coordinates and monitors case management activities throughout the care continuum, from preadmission through post discharge

4. Assists and promotes patient education and ensures the needs of both patient and family are met

5. Coordinates/analyzes data collection that may reflect patient care trends and develops into process improvement processes

6. Fosters work team participation in planning activities

7. Responsible for the human resource issues: Interviewing, hiring, counseling and performance evaluations

8. Coordinates review of the department’s policy and procedure manual, at minimum of every three years

9. Coordinates programs including Quality assessment/Performance Improvement Program

10. Ensures compliance with regulatory State and Federal guidelines

11. Assists in the development and monitoring of staffing, operational, and capital budgets

SECONDARY (modifiable)

1. Attends and participates in task forces or work groups as required

2. Assumes responsibility for special projects as assigned

3. Other duties as assigned