Job Summary

The Director of Care Management is responsible and accountable to work with the Directors of

Case Management on the implementation of the case management program at

the local level. The components/roles of the inpatient case management

program consist of the following: Care Facilitation, Utilization

Management, Case Management and Discharge Planning.

The Director is responsible for overseeing/suggesting the development of systems and

processes for care/utilization management at the local level. In

addition, the Director is responsible for monitoring the progress of

hospital department activities related to discharge planning and

clinical quality improvement. The Director works with the local level

Directors on matters that impact resource utilization and promotes the

effective and appropriate use of hospital resources. The Director

supports the collection, analysis and reporting of financial and quality

data related to utilization management, quality improvement and

performance improvement. The Director promotes interdisciplinary

collaboration, fosters teamwork and champions service excellence

Job Description

Minimum Qualifications

Education: Bachelors of Nursing (BSN) or Masters Social Work (MSW). Masters degree preferred

Licenses/Certifications:

• Current and valid license to practice as a Registered Nurse in the state of Texas or
• Current and valid Texas license as a Master’s Social Worker (LMSW) required,
• LCSW preferred and Certified Case Manager (CCM), Accredited Case Manager (ACM) or
• Fellowship of the American Academy of Case Management (FAACM) required .

Experience/ Knowledge/ Skills:

• Minimum five (5) years’ experience in utilization management, case management, discharge planning or other cost/quality management program
• Three (3) years of experience in hospital-based nursing or social work preferred
• Knowledge of leading practice in clinical care and payor requirements
• Self-motivated, proven communication skills, assertive
• Background in business planning, and targeted outcomes
• Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management
• Working knowledge of the concepts associated with Performance Improvement
• Demonstrated effective working relationship with physicians
• Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes
• Effective oral and written communication skills