Director Case Management Registered Nurse RN

Director Case Management Registered Nurse RN
Miami, FL

Currently seeking a talented and dedicated Director Case Management Registered Nurse RN for a great opportunity in the Miami, FL area. The ideal candidate will possess 5+ years of current experience working in Case Management in an acute care hospital and have 3+ years of experience working in a Case Management unit in a leadership role.

Responsibilities of the Director Case Management Registered Nurse RN

  • Reporting to the CFO, the Director Case Management and has overall accountability for the Case Management function in a facility
  • The role established objectives, directs department operation and develops overall departmental strategies in alignment with the overall direction of case management within the Division and organization
  • The Director is responsible for the results of the unit as well as the development and deployment of staff within their area of responsibility
  • Develops and implements that annual departmental plan consistent with budgetary constraints, ensuring maintenance of quality control program, provision of services with an emphasis on patient safety
  • Develops annual goals and objectives that are attainable and are appropriate to department plan and includes employee, physician, patient (customer) input
  • Integrates the department’s service within the hospital’s primary function
  • Manages the finances of the function by identifying savings opportunities or revenue enhancement that add value to the departmental or facility processes; prepares operational expense growth within hospital guidelines and based on department workload, analyzes department statistics on an ongoing basis to determine potential variances and make adjustments where necessary
  • Coordination of the Utilization Management Committee Meetings and minutes, preparation of Utilization Management monthly agenda and presentation of pertinent data. Example: Denial Activity, Peer Review Activity, and activity of targeted DRG’s
  • Responsibility to review and revise the Utilization Management Plan on a yearly basis
  • Following revisions and approval of the UM Plan by the Utilization Management Committee, the Director of Case Management is responsible to obtain approval of the plan by the Medicaid Peer review Organization
  • Assures staff compliance with the Joint Commission National Patient Safety Goals, in particular, patient identification, hand-off communication, and medication reconciliation

Requirements of the Director Case Management Registered Nurse RN

  • Current FL RN Licensure, or Recognized Compact Licensure (subject to Florida State Licensing Requirements, including/not limited to ongoing eligibility and duration provisions)
  • Bachelor’s degree in Nursing required
  • Master’s degree strongly preferred
  • 10+ years of experience in Case Management required
  • Case Management Certification preferred
  • 2-3 years of experience as a Director Case Management in acute care setting strongly preferred
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