Immediate Opportunity: Corporate Director of Case Management, Social Work & Utilization Review

Updated: May 23

DCCS has an immediate opportunity for Corporate Director of Case Management, Social Work and Utilization Review in beautiful Lynchburg, VA. This 4 hospital regional Healthcare System includes 8,100 employees, 500 employed providers and physicians, and a medical staff of nearly 800 providing care.


Qualifications

  • Current, active license as a registered nurse in Virginia or from a compact state

  • Master's Degree or higher (Required)

  • Case Management Leadership: 5 years (Required)

  • Social Work Leadership: 5 years (Required)

  • Utilization Management: 5 years (Required)

Job Description

The System Director of Case Management, Social Work & Utilization Review will facilitate the establishment of this new system-wide leadership role including assessment of structures, process, education and competencies of staff, and recommendations for development and retention systems for staff.


General Position Responsibilities:

The System Director of Case Management and Social Work plans and directs clinical operational and financial operations to ensure quality and timely flow of patients from acute care through the continuum of care for the health system. Supervises Case Management and Social Work Departments for the health system.

  • Builds diverse clinical and organizational teams to focus on efficiency patient needs and flow throughout the continuum of care utilizing team building skills.

  • Builds relationships with those involved in the discharge process throughout the continuum of care.

  • Coordinates education opportunities for the staff personnel & physicians regarding continuum of care reimbursement regulations and care issues.

  • Creates and coordinates improvement in processes for transition to continuum of care providers.

  • Demonstrates ability to make decisions balancing needs of the patient within confines of various internal and external factors.

  • Demonstrates knowledge of federal and state Medicare/Medicaid and other regulations affecting reimbursement utilization and discharge planning.

  • Demonstrates knowledge of insurance/government/contracts reimbursement methodologies.

  • Demonstrates knowledge of Interqual and multiple criteria sets and able to apply to patient populations.

  • Develops processes to improve efficiency and achieve smooth transitions to post-acute services.

  • Facilitates increasing staff members knowledge of their job duties and assists the team as needed.

  • Keeps up to date with regulations, third party payers, system processes, and continuum of care processes.

  • Maintains a positive working relationship with physicians, staff, and post-acute providers.

  • Other duties that may be assigned from time to time.

  • Performs workflow analyses payer analyses audits and looks for ways to increase efficiencies.


If you are an experienced Case Management Leader with large organization and/or health system experience, this opportunity could be of interest. If you or a colleague would like to learn more, please contact us:


Steve Grace, DCCS Consulting: sgrace@dccsconsulting.com

Mobile: (614)-531-7012.


Feel free to distribute within your network.


To learn more about CENTRA Health visit https://www.centrahealth.com/