Piedmont Henry Hospital - Stockbridge, Georgia
Organizes, directs and supervises the functions of the Care Management Department, assuring that policy and procedures are followed; proper qualified staffing levels are maintained; supplies and equipment are at sufficient levels; that an efficient department is integrated with the other departments in the hospital. The director is responsible for the development and implementation of the department’s budget. The director will assure ongoing performance improvement, encouraging educational improvement and assuring employees complete required yearly forums, for reviews and competencies. The director develops, evaluates, initiates, consults and advises the hospital in regard to performance and quality improvement and JCAHO standards related to case management. The director participates in committees with the hospital medical staff to address and resolve issues. The director continually updates processes for monitoring and managing cases under all types of insurance.
1. Directs overall department activities and program development to achieve utilization, financial, and service goals through effective communication and role modeling.
2. Assesses and provides staffing needs within budget constraints.
3. Directs the development of progressive departmental goals and objectives incorporating progressive Care Management strategies.
4. Facilitates the development, implementation, and achievement of department goals and outcomes using measurements to determine trends.
5. Set goals and objectives for dept., which are consistent with the hospital mission. Designs action plans to achieve goals.
6. Develops, updates, and implements policies and procedures for staffing, job responsibilities, and all other aspects of dept.
7. Prepare and submit annual budget timely. Monitor approved budget and other financial data to control costs.
8. Maintain dept. and regulatory manuals; maintain insurance guidelines and medical necessity criteria.
9. Oversee quality improvement activities for UR and Discharge Planning services.
10. Coordinates reconsiderations and appeals with other depts, physicians and UR Committee.