HCA, Hospital Corporation of America Director of Case Management in Lewisville, Texas

Director of Case Management

Case management is a collaborative process that assesses plans, implements, coordinates, monitors and evaluations health care delivery systems. Based on the needs and values of patients and in collaboration with all service providers, the case manager links patients with appropriate resources throughout the continuum of health care settings to assist with achievement of optimal health. Case management is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. * Oversight of operations of Case Management department * Implementation of new policy and procedures * Identifies, trends and addresses utilization issues with Medical Staff and Administration * Prepares CM, UM and PI reports and submits timely to QM and Admin as indicated * Objectively reviews CM department and documents evaluations within specified time frame * Liaison between CM, Medical Staff, Administration and other health care professionals * Development of department-specific performance improvement process * Performs Case Managers as needed to support department operations * Maintains current knowledge of Centers for Medicare and Medicaid Services (CMS), JCAHO regulations relevant to case management * Participates in staff meetings, patient care conferences and other committees as required * Participates in the orientation of new employees and cross training of other case managers * Participates in mandatory CM and hospital in-services and education programs * Participates in hospital or departmental performance improvement activities, and seeks opportunities to improve department and inter-department processes * Supports and participates in hospital safety program, infection control and other processes to ensure a safe environment * Demonstrates understanding of HCA, Medical City Lewisville mission, guiding principles and incorporates them into daily performance

  • Bachelor’s Degree in Nursing. Master’s Degree preferred; or Bachelor’s or Master’s Degree in Healthcare Administration
  • State of Texas Licensed Registered Nurse or RN Compact State License.
  • Certification in Case Management (CCM), desired
  • Minimal 7 years of managerial experience in case management
  • Demonstrated knowledge of Milliman’s Care Guideline, Interqual, and regulatory agencies
  • At least 4 years recent or past medical/surgical/ED/ICU/PCU experience
  • Must maintain current acute care clinical knowledge
  • Excellent written and verbal communication skills
  • Autonomy and reliable
  • Good organizational skills
  • Knowledge and skill regarding basic computer processes
  • Excellent interpersonal skills

Job: *Directors & Managers

Title: Director of Case Management

Location: Texas-Lewisville-Medical Center of Lewisville - Lewisville

Requisition ID: 00950-94846