Director of Case Management Location: Jackson West Medical Center, Miami, FL

Summary: Direct the day-to-day operations of the case management area, including inpatient, outpatient, mental health, and revenue cycle management.

Responsibilities:

• Lead managed care operations for Jackson Health System.
• Direct Case Management, Utilization Management, Disease Management, and Renal Management Programs.
• Develop and manage various Disease Management Programs (Diabetes, CHF, Hypertension, Asthma, AIDS DMI Project).
• Oversee the concurrent review process for PSN patients and prospective payment systems.
• Co-direct countywide Medical Management Program during disasters.
• Manage the Medical Foster Care Case Management Program.
• Adhere to compliance standards and support the commitment to ethical business practices.
• Perform all other related job duties as assigned.

Experience:

• 7 to 10 years of related experience; management experience is required.

Education:

• Bachelor’s degree in a related field required; Master’s degree strongly preferred.

Skills:

• Ability to analyze, organize, and prioritize work.
• Effective communication in both oral and written forms.
• Critical thinking and professional composure under stress.
• Sound and independent judgment.
• Knowledge of business and management principles.
• Monitoring and assessing performance for improvements.

Credentials:

• Valid Florida RN license required; Case Management certification preferred.

Working Conditions:

• Sedentary job function with occasional standing or walking.
• Frequent interaction with a diverse population.
• Possible exposure to communicable diseases and other hospital conditions.
• Personal Protective Equipment (PPE) may be required.