Director, Case Management in Fort Mohave, AZ at LifePoint Health

Date Posted: 9/22/2023

Job Snapshot

Job Description

Valley View Medical Center

$15,000 Sign-On Bonus

Who We Are:

People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Havasu Regional Medical Center is a 171-bed hospital that offers a broad scope of services in major medical disciplines. A medical staff of more than 33 affiliated physicians represents a broad cross-section of expertise in 31 medical specialties.

Where We Are:

Lake Havasu City has earned the reputation as the outdoor recreation mecca of the southwest. Blessed by an ideal climate, captivating scenery, beautiful yet rugged mountains, tranquil desert and the azure waters of the Colorado River, Lake Havasu's 45-mile long lake is an oasis of natural beauty.

Why Choose Us:

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees

• Competitive Paid Time Off / Extended Illness Bank package for full-time employees

• Employee Assistance Program – mental, physical, and financial wellness assistance

• Tuition Reimbursement/Assistance for qualified applicants

• Professional Development and Growth Opportunities

• And much more…

Position Summary:

Position will provide ongoing support and expertise aligned with strategic plan to Valley View Medical Center through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The overall goal of the position is to enhance the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and management of discharge planning. Accountable for the care, coordination and discharge planning of all patients.

Assists in developing specific departmental goals, standards and objectives which directly support strategic plan and vision of the organization.

See the detailed Leadership Responsibilities outlined below that outline Strategic Planning, Leadership, Human Resources Management, Financial Management, and Performance Improvement/Safety.

Coordinate the integration of social services/case management function into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies and healthcare facilities.

Conduct concurrent medical record review using specific indicators and criteria as approved by medical staff, TJC, CMS and other state agencies.

Acts as patient advocate: investigates and reports adverse occurrences, and performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.

Mobilizes resources and interviews, as needed, to achieve expected goal to assist in achieving desired clinical outcomes within the desired timeframe.

Ensure that patient test are appropriate utilization of services from admission through discharge.

Evaluate patient satisfaction and quality of care provided.Initiates and presents 'denial letters', as appropriate

Asses patient care required throughout continuum of care for diagnosis, procedures and DRG's

Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship.

Assist physicians to maintain appropriate cost per case and desired patient outcomes.Introduces self to patient and family and explains clinical case manager role and process for patient and family to contact clinical case manager.

Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post-hospital needs.

Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals.

Directs and participates in the development and implementation of patient care policies and protocols in order to provide advice and guidance in handling special cases or patient needs.

Coordinates the provision of social services to patients, families, and significant others to enable them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services.

Leadership Responsibilities.

1 Strategic Planning: Implementation of the Patient Services Strategic Plan aligned with the hospital’s strategic plan.

Determine avenues to improve the value (qualitative) of care and services in assigned area.

Promote both internal and external customer service through the development and implementation of programs and standards which reflect the goal of the department.

2. Leadership: Maintain personal development plan and provide management development and coaching for other members of the team.

Represent Havasu Regional Hospital and Valley View Regional Hospital at state, local and national level through involvement in professional associations and organizations.

Participate in community service.

Provide programmatic leadership of the clinical component of assigned areas to ensure quality patient care outcomes.

Develop goals, standards, policies, procedures and practices of clinical care. Implement and monitor indicators of quality.

Collaborate with interdisciplinary Directors and Medical Directors to plan, implement and evaluate services.

Promote both internal and external customer service through the development and implementation of programs and standards which reflect that goal.

Promote clinical profession by participating in professional activities. Promote family-centered approach to care delivery.

3. Human Resource Management: Assure adequate quality and number of staff by assuring adherence to the Patient Services Recruitment and Retention Plan, the Patient Services Diversity plan, and department productivity measures.

Meet or exceed yearly goals for vacancy and turnover rate.

Complete evaluations within the allotted timeframe. Assure that all staff is activity engaged in unit, divisional, and organizational shared governance activities as reflected in the minutes and other related documents.

Manage the selection, development, motivation, evaluation and discipline of reporting personnel.

Make job requirements and goals for each position clear to employees and provide sufficient training to achieve the desired level of competency; document evidence of competence on an annual basis.

Manage the development, implementation and assessment of departmental policies, procedures and philosophy as consistent with the medical center’s policies and values.

Ensure staff competency and assist with staff professional development through continuous education, literature and seminars.

Monitor and manage staffing and scheduling process.

Provide leadership for development of departmental education goals and document accomplishments. Maintain currency in field through continuing education, literature and seminars.

4. Financial Management: Assure financial accountability for annual operating and capital expenditures and budgets. Meet yearly goals for contribution margin, percent variance from budget and overtime rate.

Assure efficiencies in staffing and resource utilization by comparison with internal and external benchmarks as measured by productivity units appropriate for areas managed.

Develop and maintain systems to capture all charges.

Research and develop opportunities for revenue development for all services.

Coordinate and approve purchasing requisitions, leases, vendor contracts and service contracts.

Supervise the monitoring of inventory for the department; review service and maintenance contracts.

Prepare, coordinate, evaluate and manage annual fiscal operating and capital equipment budgets for assigned areas, evaluate and manage operating revenue/expense variances monthly and prepare written reports.

Develop methods for fiscal analysis, conduct financial and quantitative analysis and monitor existing or proposed programs and services.

5. Performance Improvement/Safety: Continually assess and improve the performance of care and services provided. Assure continual readiness for regulatory compliance.

Support performance improvement activities. Develop and maintain annual safety goal.

Ensure a high level of customer service, including family centered initiatives. Facilitate the development and implementation of evidence based practice and quality efforts.

Monitor and ensure timeliness, accuracy, availability and security of information.

Determine and enforce policies and procedures protecting patient rights for informed consent and the handling of confidential information as defined by the medical center’s mission and applicable laws and regulations.

Provide leadership to develop goals, standards, policies or procedures to ensure quality patient care outcomes.

Coordinate and document attendance at required medical center training session, including radiation safety, laboratory safety, blood borne pathogens and OSHA.

Enforce compliance with Infection Control policies and procedures.

Every effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is a logical assignment to the position. This position description does not restrict the right of management to assign or reassign duties and responsibilities with and without notice.

To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation

Job Requirements

Minimum Education

Graduate of a Program in Nursing at Bachelors of Science level or higher required.

Master's degree preferred

CCM or ACM Certification preferred

Required Skills

Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Excellent verbal, written and interpersonal skills. Capable of relating to divers age and demographic backgrounds. Analytical ability sufficient to evaluate data, make judgments and recommendations regarding operations and budgets, design protocols and create well developed reports. Professional knowledge sufficient to assure quality of care provided with multidisciplinary service areas. Demonstrated organizational leadership and management skills.If not already Case Management certified, must sit for appropriate certification within 30 month of hire (if all other criteria is met)

Minimum Work Experience

Minimum of five (5) years management experience, five (5) years of utilization review / case management experience in an acute short term hospital, five (5) years experience in discharge planning in an acute short term hospital. Requires experience with Interqual or MCG criteria software, advanced computer skills and is proficient in Microsoft Word, Excel and PowerPoint. Experience preferred with MedHost EMR and with MorCare

Required Licenses

[United States] Registered Nurse
Current RN Licensure from the State of Arizona or compact license accepted by State of Arizona.

Certifications: Basic Life Support (BLS

LifePoint Health is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans’ status or any other basis protected by applicable federal, state or local law.

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