Director of Case Management​/Swing Bed, RN

Director of Case Management/Swing Bed, RN (Full-Time)

Category:

Clinical/Director

Department:

Case Management/Swing Bed

Status:

RFT

Schedule:

Full-time, exempt position with normal business hours of Monday through Friday, 8:00 a.m. to 5:00 p.m. Occasional evening, weekend, and other after-hours work may be required based on operational needs.

Description:

The Director of Case Management, RN is a working director responsible for the daily delivery and leadership of Case Management services within Frio Regional Hospital. The Director actively performs Case Management, Utilization Review, discharge planning, care coordination, payer communication, and patient/family advocacy while leading and overseeing the hospital’s Swing Bed Program and Swing Bed Manager.

The Director works collaboratively with physicians, nursing, rehabilitation services, social services, pharmacy, Revenue Cycle, patients, families, payers, post-acute providers, and community agencies to promote safe, efficient, patient-centered care across the continuum.

The Director ensures patients receive care at the appropriate level of care and that admission, continued stay, discharge, and post-acute planning processes are completed in a timely manner and in accordance with applicable CMS Conditions of Participation, Critical Access Hospital requirements, Medicare regulations, payer requirements, Texas requirements, and hospital policies.

As a leader in a rural healthcare environment, the Director must function both independently and collaboratively, perform direct Case Management responsibilities, address barriers to care and discharge, and provide oversight and support to the Swing Bed Manager and Swing Bed Program.

The Director will also provide direct supervision and performance oversight of the Swing Bed Manager and other Case Management/Swing Bed personnel assigned to the department, as applicable.

Responsibilities include providing direction and support, monitoring performance, assisting with staff development and competency, addressing performance concerns, and ensuring departmental activities are completed in accordance with hospital policies and regulatory requirements.

Education and/or

Experience:

• Current license to practice as a Registered Nurse in the State of Texas or active Multi-State RN Compact License in accordance with hospital requirements.
• Current BLS certification.
• Bachelor of Science in Nursing preferred
  .
• Case Management certification preferred
  .
• Previous Case Management, Utilization Review, discharge planning, or related clinical experience preferred
  .
• Swing Bed and/or Critical Access Hospital experience preferred
  .
• Knowledge of CMS Conditions of Participation and Critical Access Hospital requirements preferred
  .
• Working knowledge of Medicare, Medicare Advantage, commercial insurance, authorization, medical necessity, and utilization management requirements.
• Experience with electronic health records and clinical documentation systems.
• Strong clinical assessment, critical thinking, organizational, communication, and problem-solving skills.
• Ability to work independently and prioritize multiple patients, departmental, and regulatory responsibilities.
• Ability to work effectively with physicians, patients, families, hospital staff, payers, and external healthcare organizations.

Salary Range:

Based on Experience

Job Location:

On-Site

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, national origin, sexual orientation, gender identity, marital status, disability, protected veteran status, or any other characteristic protected by law. This job description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.