DIRECTOR OF CASE MANAGEMENT SKILLS, EXPERIENCE, AND JOB REQUIREMENTS

Published: Nov 26, 2024 - The Director of Case Management brings extensive experience in acute health care settings and administrative roles, excelling in staff supervision through evaluations, counseling, and mentoring. Skilled in managing change and collaborating with team members, hospital staff, patients, and physicians to drive improvement outcomes. Demonstrates proficiency in advanced computer applications like MIDAS and CERMe, with strong capabilities in developing and monitoring operational, capital, and staffing budgets, complemented by excellent verbal and written communication skills.

Essential Hard and Soft Skills for a Standout Director of Case Management Resume
  • Case Management
  • Regulatory Compliance
  • Budget Management
  • Data Analysis
  • Health Informatics
  • Program Development
  • Quality Assurance
  • Advanced Computer Proficiency
  • Reporting Skills
  • Staff Training
  • Leadership
  • Communication
  • Problem Solving
  • Team Collaboration
  • Empathy
  • Adaptability
  • Conflict Resolution
  • Mentoring
  • Strategic Thinking
  • Negotiation Skills

Summary of Director of Case Management Knowledge and Qualifications on Resume

1. BA in Nursing with 10 Years of Experience

  • Demonstrates comprehensive knowledge of Case Management in the Acute Care setting.
  • Comprehension of the importance of clinical care progression, patient education and resource management
  • Knowledge of Utilization Review, IS/SI criteria, reimbursement issues, and HCFA guidelines.
  • Ability to recognize the needs and concerns of people and to maintain constructive relationships in dealing with them.
  • Ability to communicate effectively orally and in writing.
  • Acts as a mediator between patient concerns and administration.
  • Ability to assume twenty-four-hour responsibility for the Department of Case Management.
  • Ability to assume leadership role with the Case Management Team to coordinate the delivery of services for patients and families.

2. BA in Health Care Administration with 5 Years of Experience

  • Experience in an acute health care setting
  • Administrative experience in Case Management
  • Ability to supervise staff including staff evaluations, counseling and mentoring
  • Ability to work collaboratively with team members, hospital staff, patients and physicians
  • Ability to manage change through collaborative and leadership skills
  • Ability to facilitate processes with individuals and groups, especially with projects towards achieving improvement outcomes
  • Ability to develop and monitor operational, capital, and staffing budgets
  • Advanced computer knowledge with desktop productivity software, preferably MIDAS and CERMe included.
  • Demonstrates verbal and written communication skills.

3. BA in Social Work with 4 Years of Experience

  • Case management experience and prior management experience 
  • Prior experience in IRF or LTACH setting 
  • Knowledge of CMS Conditions of Participation Guidelines for Discharge Planning, Utilization Review, Documentation, Medicare Important Message, Face to Face Requirements, and Patient Choice
  • Knowledge of Medicare, Medicaid, and Managed Care Products and the requirements of each payer to meet the various levels of care for post-hospital services
  • Knowledge of CMS guidelines and use of level of care determination for inpatient and observation, CMS inpatient only list and other payer guidelines 
  • Knowledge of nursing, standards based practice, shared governance, organizational initiatives, in terms of theories and practices to serve as a resource and educator to others
  • Knowledgeable regarding InterQual criteria for utilization review
  • Strong knowledge of InterQual Level of Care criteria
  • Advanced knowledge of utilization management principles, concepts, and strategies including admissions criteria, levels of care, and denials
  • Advanced knowledge of commercial insurances, Medicare, Medicaid, and State/Federal regulations which impact utilization management
  • Basic Microsoft Windows desktop application and navigation skills

4. BA in Public Health with 5 Years of Experience

  • Clinical experience in acute care setting.
  • Must have knowledge of JCAHO and CMS standards as well as federal, state, and local laws pertaining to the functions of the department.
  • Must have the ability to assess information, apply critical thinking, determine best course of action, and convey necessary information to the interdisciplinary team.
  • Requires excellent communication skills, both written and verbal.
  • Strong attention to detail
  • Strong organizational skills
  • Effective leadership skills
  • Effective written and verbal communication skills
  • Knowledge of and experience with Hospital and Patient Information Systems

5. BA in Business Administration with 6 Years of Experience

  • Experience in supervisory and management principles of health care employees
  • Management or supervisory experience of Healthcare Personnel 
  • Demonstrated experience and competency in working with individuals and groups
  • Application of counseling skills in interpersonal behaviors and conflict resolution
  • Previous experience in marketing, presentation, or sales
  • Case management and discharge planning experience in an acute hospital setting
  • Knowledge of managed care and capitation
  • Experience in Case Management, Discharge Planning and Quality Improvement
  • Experience in Case Management 
  • Management or Supervisory experience 
  • Experience in an acute care setting
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