Under the general direction of the Director of Case Management, plans, organizes, and manages the functions and activities of the Case Management Department, including direction to Nurse Case Managers and Medical Social Workers in the provision of discharge planning, and social services; supervision and operational management of the utilization review program; implementation of the Clinical Documentation Improvement program; management of insurance admission notifications and continued stay certifications, supervision of appropriate documentation and entry of department functions and activities in the electronic medical record system, and facilitation of appropriate utilization of hospital resources. Assures departmental operational compliance with state and federal regulations; insures completion of departmental policies and procedures, and participates in Case Management program planning and implementation. Other duties as assigned.
-At least five years experience in a hospital clinical setting, with at least three years of experience in case management is required.
-Utilization management experience is preferred.
-Bachelor’s Degree in Nursing is required, or an approved educational plan to achieve a bachelor's degree within 4 years of hire/transfer or start of bachelor’s program or Master’s Degree in Social Work.
-Familiarity with computer equipment.
-Requires current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from a participating state in the NLC (Nurse Licensure Compact) or Wisconsin Licensed Social Worker.