Located minutes from downtown Austin, Cedar Park Regional Medical Center is a level IV Designated Trauma Center with more than 600 healthcare professionals working together to provide inpatient, outpatient, surgical and emergency care for Cedar Park and the greater Austin region.

Position Overview

We are seeking a Director of Case Management to join our team! The Director of Case Management serves as an interdisciplinary team member to coordinate the delivery of health care services leading to quality outcomes for the inpatient hospital population and their families with the limits of the financial and social resources available to the patient and his/her family. The Director is responsible for the overall case management program, including quarterly reports, appeals and denials, Utilization Review Committee and the facilitation of all case managers.

Responsibilities

• Demonstrates creativity, intelligence, and discretion in planning, organizing and coordinating department functions
• Demonstrates fiscal accountability for department resources and the ability to achieve outcome within allocated resources
• Collaborates with other departments to problem solve ongoing issues that impact department/organizations goals and/or patient care delivery
• Defines performance objectives and metrics for the department
• Applies standard admission criteria to determine necessity of admission and level of care
• Completes initial discharge planning assessment
• Collects data in an ongoing manner. Evaluates patient’s progress
• Supports patient/SO learning needs and implements appropriate measures
• Involves patient/family/SO in plan of care and works with patient/family to ensure timely & appropriate transfer to the next level of care
• Coordinates with HIM, BO, & pt registration in review decisions, discharge planning and fiscal communications
• Relate & work with various managed care representatives
• Practice capable & effective problem identification and resolution skills, sound decision making
• Obtain targeted Medicare LOS goals
• Maintains personal, financial and medical information as confidential
• Obtain self pay LOS goals
• Eliminate in-patient denials
• Reduce number of Transfer DRG’s
• Reduce avoidable days
• Ensures accurate and timely reporting of department payroll
• Completes employee evaluations in a timely manner and assess staff competencies on an ongoing basis
• Communicates and supports the hospital's mission, vision, and values, as well as departmental goals to all staff
• Incorporates quality improvement data and/or patient satisfaction data into departmental goals
• Other duties as assigned

Qualifications

• Bachelor’s Degree in Nursing (BSN) required. Master’s Degree in Nursing, or related field preferred
• Current license to practice as a Registered Nurse (RN) in Texas, or license with a compact state
• American Heart Association (AHA) approved Basic Life Support (BLS) certification required upon hire
• Minimum of ten (10) years of related case Management experience in an acute care healthcare setting with at least three (3) years in a Director level role desired
• Proven experience with needs assessment, utilization review and discharge planning
• Knowledge of Federal and State requirements: HCFA, Medicare, Champus, Medicaid, Managed Care, and knowledge of JCAHO guidelines strongly preferred
• Solid understanding of the nursing process, case management and continuity of care and reimbursement structures and CMS regulations in the acute care setting required
• Ability to read and comprehend complex clinical and financial data
• CCM or CMC highly desired

What We Offer

• Competitive Pay
• Matching 401(k)
• Medical, Dental, Vision & Life Insurance
• Generous Paid Time-Off (PTO)
• Extended Illness Bank (EIB)
• Tuition Reimbursement
• RN Loan Repayment Program
• Clinical Ladder Program
• Employee Referral Bonus Program
• Opportunities for career advancement
• Rewards and recognition programs
• Additional perks and discounts