Director of Case Management

Job Overview: The Director of Case Management leads a team of RN Case Managers and Social Work professionals who ensure seamless patient care coordination throughout the continuum of care. This leadership role requires overseeing the development and implementation of case management programs, including utilization review, discharge planning, throughput, and resource navigation. Success is measured through key performance indicators - such as readmission rates, patient flow, patient satisfaction, length of stay, and cost-effectiveness. The ideal candidate will be skilled in leadership, communication, problem-solving, and strategic planning. Qualifications: Required: NJ LSW, LCSW, or RN required. If RN, bachelors degree in nursing is required. Masters preferred. If SW, Masters required. Case Management Certification preferred or obtained within one year. Knowledge of level of care criteria / care guidelines Progressive hospital leadership positions Scheduling Requirements: Full-Time Day 40 hours per week Essential Functions: Directs the integration of house-wide data for reporting in accordance with the hospital utilization management plan by directing the Case Management Department to identify and trend clinical denials while maintaining a focus on quality of care. Consistently maintains and ensures the effective use of a software program to track pertinent information regarding quality outcomes, denied/avoidable days and referrals to QRM, Risk Management, and/or Physician Advisor. Directs annual goal setting and updates the Case Management Department plan in accordance with the hospital-wide goals and objectives. Evaluates Case Management model on an ongoing basis and restructuring when necessary to ensure Case Management services are optimized. Participates in strategic planning, evaluation and program development for the Case Management Department and maintains ongoing reporting to Senior Management of all activities Works together with Medical, Ancillary and Senior Management to accomplish Case Management related activities. Takes a proactive approach in mentoring and counseling staff, provides progressive discipline as needed up to, and including, termination of staff members who do not meet the requirements of their position. Supports teamwork when appropriate by researching and sharing information involving Case Management staff, medical staff, patients/families and visitors to cooperatively solve problems and help out when time permits Oversees all Case Management staff activities, which includes monitoring the appropriateness and medical necessity of admissions, continued stay, and discharge planning. Assists in the development and implementation of Case Management tools, such as multidisciplinary care protocols, risk assessment tolls, patient/staff education material and participation in interdisciplinary round process. Develops all Case Management Department policies and procedures, maintains current knowledge and application of all regulatory standards related to Case Management and coordinates staff education/compliance with these policies. Facilitates successful orientation, development and continuing education of the Case Management Department. Ensures the Case Management staff provides a secondary role meeting core quality indicators Maintains current knowledge of National Patient Safety goals and supports a culture of safety. Enhances professional growth and development to keep abreast of the latest trends in Case Management/Hospital/Administration services Benefits and Perks: At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health. Paid Time Off (PTO) Medical and Prescription Drug Insurance Dental and Vision Insurance Retirement Plans Short & Long Term Disability Life & Accidental Death Insurance Tuition Reimbursement Health Care/Dependent Care Flexible Spending Accounts Wellness Programs Voluntary Benefits (e.g., Pet Insurance) Discounts through our partners, such as NJ Devils, NJ PAC, Verizon, and more. Choosing RWJBarnabas Health. RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health. RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education. RWJBarnabas Health is an Equal Opportunity Employer RWJBarnabas Health is an Equal Opportunity Employer