Director of Case Management and Discharge Planning

Samaritans Director for Case Management & Discharge planning collaborates and facilitates Case Management and Discharge Planning processes in order to assess, plan, implement, coordinate, monitor and evaluate options and services to meet and individuals health card needs through communication and coordination of resources to promote quality, cost effective outcomes. The positions requires a high level of organizational skills along with the ability to set assignment priorities and work independently with a minimum amount of supervision. The person must be able to tactfully interact with patients, families, medical providers, the multidisciplinary care team and outside resources. A high regard for confidentiality is required.

Principal Duties and Essential Functions

• Knowledge of UR Conditions of Participation including objective criteria for appropriateness of hospital admission and various levels of care.
• Continued support, participation and facilitation of Multidisciplinary Rounding Processes
• Facilitating clear concise communication processes between the facility and payers
• Maintaining positive relationships with long term providers, home care agencies, social service agencies, PCP offices, Hospice, and other community resources
• Computer literate in Excel, Word, Powerpoint
• Excellent verbal and written communication skills
• Knowledge of CMC regulations surrounding Discharge Planning and requirements for continuum of care
• Strong patient and family advocacy
• Knowledge of Family Healthcare Decision Act and implications as well as strong understanding of Advanced Directives
• Oversight of inpatient denial management
• Ability to collaborate and communicate among disciplines to problem solve
• Knowledge of payer intricacies in relation to patient status and level of care
• Oversight of management of patient cases both in the inpatient, observation and outpatient (BHU) setting to ensure patients are receiving treatment and care across the continuum
• Oversight of PRI (Patient Review Instrument) and Screen completion
• Oversight of ALC population and facilitation of family discharge planning meetings as necessary
• Collaboration with Readmission reduction via multidisciplinary team
• Participation in current hospital initiative task forces
• Participation in Revenue Cycle work group and Corporate Compliance Committee
• Presence in outside advisory board work with community resources
• Quarterly review of PEPPER report
• Facilitating staff communication including staffing meetings
• Staff support and advocacy, reinforcement of patient and family education regarding discharge planning and regulations processes
• Direct responsibility for budgets of three departments
• Supervision of approximately 25 employees including scheduling and timekeeping management
• Annual staff evaluations, goal setting, management of job requisitions in Taleo for position control
• Knowledge of accreditation and regulatory requirements
• Direct reporting to Medical Management committee regarding UR/Case Management processes
• Bridging gaps for uninsured/ underinsured individuals to access payment for needed care and treatment in the post acute care setting

Samaritan is an Affirmative Action/Equal Opportunity Employer. Women, Minorities, Disabled, and Veterans are encouraged to apply.

Job Type: Full-time

Pay: From $1.00 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: One location