A director of case management in healthcare holds an executive leadership position that requires clinical experience and an advanced degree. Individuals in this role must also possess comprehensive knowledge of the healthcare industry, familiarity with government regulations on healthcare plans, strategic planning skills and an understanding of the operations of a healthcare organization.
Case management nursing involves planning, assessing, monitoring and managing patient care. A goal of case management is to ensure that patients receive care in the most cost-effective manner. RNs working in the case management department of a healthcare organization are responsible for determining patient eligibility for certain treatments, coordinating patient services and developing treatment plans. Case management nurses work with patients and their families to ensure that the treatment being received will lead to desired health results.
Job Description and Duties
In most healthcare organizations, a director of case management is responsible for directing all activities within a department. Specific job duties may include developing and maintaining quality-improvement programs, managing payroll, collaborating with physicians and medical staff to ensure service expectations are being met, directing the workflow of other case managers and developing departmental policies and procedures.
The healthcare director of case management serves as a resource for the case management team and other departments, and usually reports to the CEO, CFO or vice president of a healthcare organization. This position may also require direct supervision of other case managers and medical staff. A director of case management may perform other important administrative duties such as:
- Prepare staffing plans and schedules
- Conduct performance appraisals and make hiring decisions
- Provide training on governmental regulations
- Develop and implement programs to optimize patient care
- Promote and maintain positive relations with patients and their families as well as other healthcare organizations
What Are Employers Looking For?
Employers generally require that director of case management candidates have an in-depth understanding of the healthcare system, experience managing others, knowledge of federal and state regulations, and the ability to manage budgets. Applicants should also have the following:
- Current licensure as an RN
- Comprehensive knowledge of healthcare principles and practices
- Excellent critical-thinking, problem-solving and analytical skills
- Ability to lead and motivate others
- Strong self-initiative and interpersonal communication skills
- Fluency in the compliance and regulatory standards governing health plans and patient care
- Proficiency with computers and a talent for research and data analysis
Education and Training
Directors of case management generally begin their career as an RN within a clinical setting. With experience and solid performance, RNs can advance to administrative positions with greater responsibilities. Management-level roles usually require an advanced degree in nursing, along with extensive clinical and case management experience. Most employers require at least a Bachelor of Science in Nursing (BSN) to qualify for management positions, although a Master of Science in Nursing (MSN) degree is generally the standard for director-level roles.
Typical Salary of a Healthcare Director of Case Management
According to the U.S. Bureau of Labor Statistics (BLS), the median salary for medical and health services managers was $96,540 as of May 2016. The first step toward a director position may be a nurse case manager role.
The (BLS) reports in the 2016-17 edition of the Occupational Outlook Handbook that the job outlook for health services managers remains good, with employment in healthcare administration predicted to grow much faster than other occupations (20% through 2026). The best job opportunities will typically go to experienced RNs with at least a BSN or, more commonly, an MSN degree.
Employers generally prefer a strong clinical background combined with an advanced degree and extensive medical knowledge, as they are indicators that a director of case management will perform well in today’s ever-changing healthcare environment.