NHS Solutions has a new opportunity for an Experienced Interim Nurse Leader in Case Management. The Director, Care Management is responsible for leading, coordinating and managing the quality, safety and effectiveness of patient care transitions from and related to, the acute care setting.  These include transitions to ambulatory, post-acute, and community settings. The Director will lead a team that directs and facilitates relationships among hospital, ambulatory, and community based providers for seamless continuity of care, including but not limited to physician offices, clinics, hospices, skilled nursing facilities, home health agencies, LTACs, and other post-acute and community entities.

The Director is responsible for the daily oversight and management of case management, social work, utilization review, compliant documentation, and resource utilization, and will provide a leadership role in innovative care management and alternative reimbursement models.  The Director will report directly to the VP Quality.

Key Requirements:

  • Current RN License in designated state
  • Bachelors Degree in a related field
  • Masters Degree required (in Healthcare Administration strongly preferred)
  • Certified Case Manager (CCM) or certification in care management related discipline
  • Excellent organizational, communication, interpersonal and public speaking skills
  • Experience with personnel management in including recruitment, job description development and disciplinary processes
  • Experience with developing, administering, and monitoring budgets
  • 5 years recent experience in complex case management, long term stays, including nurse assisted case management, utilization management, and disease management
  • Experience with performance improvement including CMS and TJC core measures
  • Prior experience working with multidisciplinary group practice and/ or community based programs and facilities
  • Experience in translating objective and measurable data into effective written and verbal communication
  • The ability to develop and communicate, policies and procedures
  • High level of competency with MS Offices and health information technology
  • The ability to evaluate and perform data analyses using Microsoft Excel or equivalent
  • RAC Certification or RAC Certification eligible is preferred

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