Director, Case Management

Directs, plans, implements and evaluates all activities of the case management program. Develops processes to monitor utilization review inclusive of length of stay (LOS) and resource reduction strategies, excess days throughput and industry benchmarks. Capitalizes on facility best practices and makes recommendations for process improvement. Oversees resource utilization for the hospital and provides specific data analysis on utilization to the committee to drive performance. Acts as a liaison to regulatory agencies to ensure compliance of requirements and to ensure third party payers reimbursement/ coverage is approved to meet patients’ level of care. Oversees the coordination of care and transitions of care processes and outcomes across the continuum and provides data and analytics to drive performance improvement in this area.