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Director Case Management

Company: MercyOne
Location: Sioux City
Posted on: August 4, 2022

Job Description:

Employment Type:Full timeShift:Day ShiftDescription:Under general direction, designs, develops and directs a case management delivery system across the continuum of care. Service areas of responsibility include Medical Social Services/Discharge Planning/ Utilization Management. Collaborates closely with others in the community healthcare system to plan, develop, implement, promote and evaluate case management services across the continuum and to improve existing services; with the objectives of meeting the admission and discharge needs of the patient within the reimbursement constraints and to promote appropriate quality care in the appropriate setting.Your best life. Our one purpose.At MercyOne Siouxland, we work continuously to inspire one another and are dedicated to do what is right. Our colleagues are proud to go the extra mile.What we offer:We care about your wellbeing, both physical and mental, which is why our benefit package includes:Wellness programsEducation reimbursementPersonalized health insurance plans including dental and visionPaid time offLong- and short-term leaveRetirement planningLife insurance coverageWhat you will do:Directs case management staff by reviewing problems, needs, and concerns; and recommending appropriate courses of action, to assure the delivery of highest quality services, which are consistent with the philosophy, mission, and vision of MercyOne Siouxland Medical Center and MercyOne Medical Group.Maintains a current knowledge of regulations and policies of State, Federal and Private regulatory and surveying agencies, and communicates pertinent information through written and verbal avenues to physicians, committees, department/program directors, subordinates, team leaders, interdisciplinary team members, and related agencies throughout the CHCS.Coordinates with all departments the implementation of interdepartmental systems changes relative to case management services.Develops and coordinates the use of internal reporting systems to optimize case management services.Facilitates communication of all disciplines involved in the overall management of the DRG reimbursement system by serving as the primary contact person/liaison for related information and/or concerns.Serves as the liaison for the fiscal intermediaries, as related to denials of payment for medical necessity and potential focused medical review audits.Continues to research, review, consider, and incorporate new strategies in the delivery of case management services across the continuum of care.Maintains state-of-the-art technical/practice skills through participation in workshops and conferences, professional group membership, review of current literature and professional journals.Serves on internal and external committees, task forces, advisory boards, and governing boards, which promote the health, welfare, and well-being of patients, health care employees, and citizens of the community served.Participates in regularly scheduled supervisory meetings with senior leadership to review overall operations of the Case Management Department.Develops and maintains a cooperative relationship with community health, welfare and social/family services agencies, home health agencies, durable medical equipment distributors, and long-term care facilities, in order to provide discharge planning and additional follow-up care for patients and their families.Coordinates case management functions with other patient care services, gathers and exchanges relevant data, elicits cooperation, and minimizes duplication of services as identified.Formulates policies and procedures for the Case Management Department, to facilitate the delivery of appropriate services and to maintain quality standards of practice. Monitors implementation to assure compliance with hospital-wide, corporate and national policies and standards of quality for case management services.What we are looking for:Requires a Master's Degree in Social Work (MSW) or Nursing (MSN) from an accredited school of Nursing.Requires a minimum of three to five years managerial/supervisory experience in a health care setting.Requires a minimum of five years prior experience in an interdisciplinary setting.National Certification in specialty area is required within 1 year of hire.Excellent interpersonal/listening skills to interact effectively with individuals of all backgrounds, experience and educational levels.Excellent written/oral communication skills. Demonstrates ability to communicate effectively with staff, physicians, and other allied health professionals.Individual should be dynamic, creative and intelligent.Why MercyOne Siouxland?MercyOne Siouxland Medical Center is a 238-bed regional center that provides residents in a 33-county tri-state region an entire continuum of preventive, primary, acute and tertiary healthcare services. MercyOne Siouxland Medical Center is home to the only Level II trauma center in western Iowa - one of only four trauma care facilities in the state to receive verification from the American College of Surgeons - and MercyOne Air Med, a regional helicopter ambulance service.About MercyOne and Trinity HealthWe are MercyOne: a connected system of health care facilities and services dedicated to helping you and your community live your best life.More than 20,000 colleagues strong, our care providers and staff make your health and happiness their highest priority, so you can get well-and stay well. With 420 care locations, our clinics, medical centers and affiliates are never too far from home, allowing us to improve the lives of individuals and communities across the state of Iowa and beyond.MercyOne Siouxland is a proud member of Trinity Health, one of the nation's largest Catholic healthcare delivery systems, our network spans 22 states, 94 hospitals and 133,000 colleagues nationwide.About SiouxlandThe tri-state region, referred to as Siouxland, is highlighted by safe and friendly communities, excellent schools and a mix of peaceful rural areas and vibrant city atmosphere where Iowa, Nebraska and South Dakota meet at the Missouri River.Situated in the heart of Downtown Sioux City, MercyOne Siouxland Medical Center is also well positioned for urban living in any of the newly renovated apartment, downtown loft, or townhome living options. The downtown also features a historic district with excellent restaurants and social spots and you'll just be steps away from the beautifully-renovated Warrior Hotel for dinner and the gorgeous Orpheum Theatre for entertainment.The MercyOne Mission Defines Us:MercyOne serves with fidelity to the Gospel as a compassionate, healing ministry of Jesus Christ to transform the health of our communities.Our timeless values guide us:ReverenceIntegrityCommitment to the PoorCompassionExcellenceJusticeStewardshipMercyOne Cultural Beliefs Direct Us:Be ONE: I benefit from and strengthen MercyOne.Personalize Care: Your experience. My responsibility.Own It!: I own my actions to deliver our key results.Improve Daily: I make improvements every day for those we serve including each other.Innovate: I imagine and embrace bold new ideas to revolutionize health.MercyOne Siouxland and all its affiliates are proud to be equal opportunity employers. We do not discriminate on the basis of race, gender, religion, physical disability or any other classification protected under local, state or federal law.Trinity Health's Commitment to Diversity and InclusionTrinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

Keywords: MercyOne, Sioux City , Director Case Management, Executive , Sioux City, Iowa

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