Director-Case Management

Job ID: DDZ Tupelo Management - CASE MANAGEMENT Full Time - Day Posting Description

At North Mississippi Health Services, our mission is to continuously improve the health of the people of our region. Our vision is to provide the best patient and family-centered care and health services in America. We believe that fulfilling our mission and vision calls us to embrace the best people that form incredible connections to our patients and families.

We take pride in celebrating everything that makes you uniquely you your talents, your perspectives, and your passions. At North Mississippi Health Services, we believe in connecting your passion with a purpose. When you are part of our team, you know what connected feels like.

#WhatConnectsYou Job Description

Supervision: Direct daily activities of the Care Coordinator and indirect activities of Utilization Management. Responsible for development and implementation of specialty case management program. Lead in cost/benefit analysis to achieve cost efficient care coordination for both patients and NMMC. Ensure the provision of quality, cost effective care and services. Lead in development, monitoring, and evaluation of treatment plans and progress. Provide oversight of Patient Assistance Fund Ensure appropriate resolution of care connections and/or grievances. Hold primary responsibility for departmental strategic plan, scorecard and reporting.

Care Coordination: Develop and implement discharge planning activities in conjunction with Physician, Care Coordinator, RN Utilization Coordinator, Spvr., Utilization Management, family, Nursing and ancillary services for risk patient population. Perform case finding and receive referrals for outlier patient population. Offer counseling and direct social work services to assist with meeting psychological needs of patient/family. Assess and implement appropriate intervention to address identified patient needs and maintain regulatory requirements. Consulting: Work collaboratively with Compliance Officer in achieving and maintaining compliance with Federal and State Guidelines. Actively participate and make recommendation in Medical Ethic Committee. Act as a consultant to ITS for Case Management software and clinical guidelines . Serve on Readmission Committee. Lead in Safety Solution resolution.

Patie nt Care: Conducts assessments to determine patient needs and barriers to disease management, care coordination and transition of care needs . Document assessment findings in the clinical record according to established standards Collaborates with Risk Management and Legal as appropriate.

Liaison : Serves as liaison for physician/provider services Serves as liaison with local department of health reporting services (APS/CPS) Serves as internal consultant for all issues pertaining to social services/patient/employee advocacy.

Regulation : Adheres to NMHS/NMMC Policies/Procedures/Guidelines Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues Refers all potential quality care issues to the Case Management Director daily to facilitate timely follow-up Job Knowledge:  Masters Degree in Nursing or Social Work; required. Licensed as a Registered Nurse by the Mississippi Board of Nursing; required. Minimum of 2 years in supervisory role/management role; required. Minimum of 5 years in case management experience; required. Minimum of 5 years clinical and/or healthcare experience; required. Acute care experience within last 2 years preferred. Knowledge in basic software programs such as Microsoft Word, Excel, and PowerPoint; required Excellent organizational and communication (written and verbal) skills; required Excellent interpersonal skills; required Ability to serve patient population from pediatric to geriatric; required Requirements

The following are requirements in addition to any stated in the above description. Licenses

You must have the following licenses to apply: Registered Nurse and Licensed Social Worker Education

You must have the following education to apply: You must have a Masters or higher