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PiedmontPosted 2 months ago

Director - Care Management

On-siteAugusta, Georgia, United States

Full TimeSenior LevelEnterprise

Job Summary

Lead the Care Management department by defining standards of practice, managing performance improvement, operations, human resources, and financial strategies. Deliver case management and social work services per evidence-based guidelines while promoting quality patient throughput through effective care coordination and discharge planning. Analyze key metrics such as Average Length of Stay and Case Mix Index to monitor effectiveness, collaborate with Utilization Management and Revenue Cycle, and oversee staff utilization based on workload and acuity. Recruit and retain talent, implement HR policies, and ensure personnel files meet industry standards. Participate in strategic planning, maintain a safe work environment, and conduct outreach with community-based providers to support departmental goals.

Required Qualifications

  • Graduate from a nursing program
  • Bachelor's Degree in Social Work, Healthcare Administration, or other related field
  • 7 years of case management or social work experience in an acute care setting
  • three (3) years of management experience in the acute setting
  • Experience using InterQual
  • Experience using Milliman
  • Licensure or eligible for licensure, in the state of Georgia for one of the following: Upon Hire
  • RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Unrestricted registered nurse (RN) license, or eligible for RN licensure, in the state of Georgia
  • LMSW - Licensed Medical Social Worker - State Licensure current unrestricted licensed Master Social Worker (LMSW)
  • LCSW- License Clinical Social Worker licensed Clinical Social Worker (LCSW)

Desired Qualifications

  • Master's degree
  • Additional certification
  • Master's in healthcare administration and / or finance
  • CCM - Certified Case Manager or Certified Care Management

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