Director, Case Management​/Care Transition

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The Director of Case Management/Care Transitions leads a collaborative case management effort by coordinating the care and services of patient populations at the assigned facility. Provides clinical leadership for the care management team by serving as an educator, role model, patient advocate, and change agent to achieve optimal clinical, financial, and resource outcomes. Leads the Transitions of Care program for specific patient populations transitioning from inpatient to outpatient care.

Oversees daily team activities and provides strong leadership through training, coaching, teaching and managing assigned teams. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

The Director of Case Management/Care Transitions leads a collaborative case management effort by coordinating the care and services of patient populations at the assigned facility. Provides clinical leadership for the care management team by serving as an educator, role model, patient advocate, and change agent to achieve optimal clinical, financial, and resource outcomes. Leads the Transitions of Care program for specific patient populations transitioning from inpatient to outpatient care.

Oversees daily team activities and provides strong leadership through training, coaching, teaching and managing assigned teams. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

• Case Management
  • Provides clinical guidance and supervision to all case management programs, based on accepted principles of nursing, social work, and case management practice.
  • Provides leadership to the interdisciplinary team (RNs, APNs, Social Workers, Utilization Review) to achieve optimal outcomes through the tools of care management.
  • Collaborates with stakeholders to continually streamline, standardize, and systematically implement best practice case management processes, including interfaces with revenue cycle.
  • Develops and implements case management programs, including utilization review, intake, and discharge planning.
  • Manages and monitors department activities to evaluate the productivity and quality of programs and processes in order to identify potential improvements and ensure maximum performance.
  • Develops and administers budgets for operational areas, authorizes expenditures, and monitors budget and other financial indicators. Assists in the development and implementation of plans to control costs and improve department operations.
  • Develops and maintains professional networks and relationships with hospitals, physicians, community resources, and other providers to promote continuity and quality of care.
  • Uses a collaborative approach with physicians and the multidisciplinary team to facilitate care and eliminate barriers for the designated case load. Ensures that the plan of care and services provided are patient focused, high quality, efficient, and cost effective. Seeks care plans that balance clinical and financial concerns with the family’s needs and the patient’s quality of life.
  • Uses data to drive decisions and plan/implement improvement strategies for assigned patients, including fiscal, clinical, and patient satisfaction data.
  • Initiates and leads the development, implementation, evaluation, and revision of clinical pathways.
  • Ensures that policies and procedures are developed and enforced in alignment with standards of patient care and regulatory bodies, and that the core components of case management processes are followed.
  • Works in collaboration with other key stakeholders to remain current on regulatory requirements. Participates in the development of standardized processes to fulfill compliance with all CMS and regulatory agencies’ statutes/standards specific to utilization…