Director of Resource Management
Location: Midwest City Oklahoma
Description: Midwest Regional Medical Center is currently seeking to employ Director of Resource Management right now, this job will be placed in Oklahoma. For complete informations about this job opportunity please read the description below. PURPOSE: Supervises the operations of the Case Managers, Social Workers and Pastoral Care. Works with the Chief Financial Officer on reviewing pati! ent medical records to insure proper utilization of hospital services and resources. Responsible for coordinating patient needs with institution resources to promote cost effective care with quality outcomes. As a patient advocate, the Director of Resource Management will remain attentive to the care of clients across a continuum of care settings and phases, therefore, promoting continuity of the care plan, with emphasis on customer satisfaction.
JOB RELATIONS:
A. Responsible administratively to the Chief Financial Officer and clinically to Resource Management Physician Advisor.
B. Supervises Case Managers/Social Workers/Chaplain.
C. Works closely with other clinical managers and department heads.
D. Maintains effective written and oral communication with all hospital personnel, medical staff, patients, family members and the public on a daily basis.
ESSENTIAL FUNCTIONS:
1. Monitors patient medical records t! o insure appropriate and quality utilization of hospital resou! rces.
1.1 Performs admission, concurrent and focused reviews using InterQual Severity of Illness/Intensity of Service (SI/IS) criteria.
1.2 Maintains computer or paper record of data obtained from admission, concurrent, and focused reviews.
1.3 Performs retrospective reviews or studies following designated guidelines established by various clinical disciplines.
1.4 Demonstrates an ability to identify cases where SI/IS criteria are not met. Contacts physicians for additional information and suggests alternatives if admission/continued stay is not appropriate.
1.5 Consults with Physician Advisor regarding specific patients per designated guidelines. Uses initiative and good judgment when referring cases to Physician Advisor.
1.6 Provides data on utilization practices to Hospital/Medical Staff.
1.7 Provides clinical information to private review organizations, and maintains communication as required to obtain certi! fication for the admission and continued stay. Prepares for on-site monitoring reviews by third party review organizations.
1.8 Establishes effective working relationships with medical and hospital staff to educate and coordinate usage of resources and services as evidenced by reduced length of stay.
1.9 Notifies director of potential or identified problem areas that concern length of stay or financial issues.
1.10 Monitors and updates InterQual criteria application for consistency with Midwest Regional Medical Center standards of care and scope of practice in clinical units.
1.11 Participates in twice weekly Departmental Patient Care Conferences to discuss case management and utilization issues.
2. Assesses patients, identifying any discharge needs, and coordinates appropriate post hospital plans to facilitate a timely discharge when medically stable.
2.1 Regularly collaborates with physicians, nurses and other health c! are personnel to discuss patient care, therapeutic modifications, and d! ischarge planning.
2.2 Screens all cases for early identification of “high risk†patients according to established criteria.
2.3 Utilizes nursing and discharge planning psychosocial assessments, patient and family input, physician communication and progress notes, nursing notes and communications, case manager and interdisciplinary notes to coordinate and facilitate a discharge plan that is appropriate for the patient’s needs post hospitalization.
2.4 Assures that patient care staff and physicians are kept informed of discharge plans by providing a continued system of communication through documentation in the medical record according to established procedures.
2.5 Consistently documents patient and family involvement in the discharge planning process as indicated in the progress notes.
2.6 Consistently monitors compliance with standards of care by observations and written documentation; regularly communicates results to ap! propriate staff members; develops a plan to increase compliance and implements actions to correct deficiencies.
2.7 Rotates 24-hour on call responsibility to assist with discharge planning and appropriateness of admissions.
3. Is familiar with patient’s DRG and has knowledge of how the DRG is assigned, the reimbursement and the average length of stay for the DRG.
3.1 Accurately assigns a working DRG for all patients based on the admission diagnosis and plan of care.
3.2 Updates DRG when patients condition and/or treatment changes.
3.3 Educates physician and ancillary staff in documentation regarding appropriate DRG.
3.4 Provides an updated list of patient DRG’s to Health Information Management on first day of each month.
4. Maintains interdepartmental records, confidentiality of information and submits reports as indicated.
4.1 Keeps accurate records of patients that are assessed.
4.2 Maint! ains confidentiality of patient and department information, releasing o! nly in accordance with the hospital policy and/or the approval of the department director.
4.3 Assures the security of the department files at the end of each work day to protect confidential information.
5. Interacts with medical and hospital staff to facilitate the recognition and resolution of case management issues.
5.1 Attends meetings as designated by department director.
5.2 Demonstrates responsibility to others with competent and timely follow-up on matters requiring additional attention.
5.3 Demonstrates an ability to communicate effectively and expresses comments and ideas clearly when interacting with medical staff, coworkers, and other internal and external professionals. Actively listens and always follows appropriate channels of communication.
5.4 Demonstrates an ability to identify and solve problems; uses initiative and good judgment to reach quality decision; works with staff to solve interpersonal confl! icts and problems without the need to involve the Director and other administrative personnel.
6. Enhances professional growth and development.
6.1 Obtains case management certification when achieves appropriate case management experience to sit for exam.
6.2 Attends continuing education courses related to case management and utilization management.
6.3 Attends and participates in departmental meetings.
6.4 Establishes and maintains a good rapport and professional working relationship with the medical staff and hospital department managers.
7. Performs other related duties as assigned or requested.
7.1 Demonstrates behavior of cooperation and professionalism when assisting with other related duties.
7.2 Performs and completes special assignments in a timely, accurate and organized manner.
7.3 Demonstrates the ability to adapt to change in workload and assignments.
8. Works with CFO to ! supervise the activities of Case Managers, Social Workers and Chaplains! in the Resource Management Department.
8.1 Interviews and participates in the employee selection process.
8.2 Trains new employees utilizing orientation guidelines and checklists.
8.3 Provides ongoing inservice documents for employee files.
8.4 Maintains daily production monitors as needed.
8.5 Maintains and updates work schedules as needed.
8.6 Provides coverage in areas to keep department current.
8.7 Documents input in employee evaluations and counseling.
9. Sets and maintains professional image within department.
9.1 Dresses in professional manner.
9.2 Helps develop and enforce dress code within department.
9.3 Trains employees to exhibit a positive “Customer Relations†attitude.
10. Assures Hospital and Department policies are carried out. 1
0.1 Assists CFO in creating, implementing and reviewing Policies and Procedures as needed.
10.2 Revi! ews Job Descriptions and updates annually or as needed.
10.3 Develops and revises Resource Management Department Education Plan annually.
10.4 Assist Director in disseminating and monitoring compliance with Midwest Regional Medical Center policies.
Requirements
QUALIFICATIONS: Education: Graduate of an accredited school of nursing or accredited graduate college. RN or LCSW. Experience: Three years med/surg experience. Working knowledge of Medicare and Medicaid regulations. Minimum of two years experience as a Case Manager or Social Worker in a medical setting.
Management Skills: Excellent human relations and oral/written communication skills. Ability to prioritize activities and plan work effectively. Capable of functioning in a stressful environment with appropriate interpersonal skills. Problem solving/decision making abilities.
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If you were eligible to this job, please email us your resume, with s! alary requirements and a resume to Midwest Regional Medical Center.
If you interested on this job just click on the Apply button, you will be redirected to the official website
This job starts available on: Mon, 24 Jun 2013 09:41:24 GMT
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