Director Care Management

Responsible for directing the overall Care Management program, staff, and operations including resource allocation, budgeting, planning, and regulatory compliance. The Director CM sets priorities and provides administrative leadership for functions of utilization review, care management/care coordination, denial management, social work, and transition planning. He/she provides leadership and direction to ensure department roles and functions support consistent practice and outcomes involving appropriate level of care, resource utilization, associated revenue cycle activities, safe patient discharge, care transitions, and readmission prevention. The Director works collaboratively with the Physician Advisor and participates in System and Organizational Performance Improvement initiatives; works to build relationships with key internal and external stakeholders; provides education about CM program functions, payer, and regulatory requirements including current trends and potential impact on the department, hospital or system.

Education Requirements

4 year Bachelor's Degree in Nursing, Healthcare Administration (Required)

Experience Requirements

Master's Degree in Nursing or related field (Preferred)

4 years of Acute care case management (Required)

5 Years of Management and leadership experience with a minimum of 2 years at the Director level in a comparable setting (Required)

CERTIFICATIONS AND LICENSURES

Required Certifications/Licensures: Registered Nurse (RN) with a current Georgia license OR a Licensed Clinical Social Worker (LCSW)

Preferred Certifications/Licensures: Certified Case Manager (CCM), Accredited Case Manager, Case Management Administrator Certified