Director, Hospital Case Management

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Prisma Health
June 11, 2019
Columbia, South Carolina
Job Type


Director, Hospital Case Management


Case Management

Req Number



Full-time FTE 0.9 -1.0




8 a.m.-5 p.m., Monday-Friday

Job Details

Masters Degree Required
5-8 years experience required

Job Summary:

Responsible for the programmatic development, planning, organization and system wide strategic direction of the inpatient departments and functions that focus on the management of patient outcomes.   Functions include but are not limited to: Inpatient Case Management, Social Work and Utilization Management. The Director promotes interdisciplinary collaboration with medical staff, nursing, hospital and system leadership, fosters teamwork and champions service excellence.

All team members are responsible for bringing life to our Purpose Statement – Inspire health. Serve with compassion. Be the difference – through every action and every interaction at work.


Demonstrates a broad knowledge of clinical practice using innovative critical thinking skills. Demonstrates expert knowledge of HCM functions including but not limited to working knowledge of medical necessity criteria, patient management, case management documentation systems, and all other systems used in the daily case management activities.

Mentors, supports, and develops Case Management Leadership team in their job functions and responsibilities and professional growth and development

Works collaboratively with Physician Advisor team to identify deviations from standard practice and to implement or develop interventions to support service recovery. Works with staff to mentor, advise and support effective change in esponse to identified barriers

Consult and collaborate with system directors, administrators, senior management, nursing and medical staff leadership in planning to meet patient needs; system goals & objectives to assure quality continuity of patient care and effective utilization management. Plans and leads implementation of new programs for the organization to support effective continuum of care.

Continuously assesses and improves the department's performance by designing operational processes, monitoring performance through data, analyzing the data, implementing sustainable performance improvement, and participating in multi-disciplinary, inter-departmental PI activities.

Plans, organizes, and directs the programs and operations of Hospital Case Management.

Responsible for financial management activities for the department to include the development and management of applicable budget processes.

Responsible for the management and reporting of all regulatory compliance efforts with various applicable regulatory agencies.


Education: Master's degree in Nursing or related field or Masters in Social Work.

Experience: At least 5 years' management experience within inpatient case management.

Number and Type of Employees Supervised: 2-5 direct reports. 101-150 indirect reports.

Licensure, Registry or Certification Required: Currently licensed or eligible to be licensed as a Registered Nurse (RN) by the South Carolina Board of Nursing, or, LMSW (Licensed Masters Social Worker) or LISW (Licensed Independent Social Worker) (Lawson Code LLSW). Accredited Case Manager (ACM) or Certified Case Manager (CCM) preferred.

Special Training: Utilization Management, Regulatory and administrative environment in which the organization functions: COP, TJC and others. Medical Necessity Criteria (Interqual, MCG) knowledge and experience. Case management; care coordination, quality indicators in a tertiary care hospital.






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