OP, have you ever worked as a Case Manager either inpatient or outpatient? Have you ever performed discharge planning, chronic/specialty planning, UR, etc.? Have your ever managed Case Managers?
Your questions are not only vague but they have led me to believe that you do not know much about Case Management. However, your posts read as if you are tasked with re-organizing a department of which you know nothing. Thus, you may need much more guidance then this forum can provide. Go off line and perform research.
Talk to your staff, your peers, and read about various models that work for your facility and what is not working. Learn more about the government policies that impact our practice. Learn your facility's role in your local area. Learn the expectations of insurance companies and their reimbursement rates. Grow your knowledge that way and you may have a better idea of how to re-organize your department.
On the other hand, another forum that may be of some help is the Nurse Management forum. Those nurses (many of them) have managed various departments forever....: Nursing Management. Good luck!
If you have one position to do UR, CM, and DCP, be prepared for your hospital to lose money or have a good appeals dept. because they probably will be so busy dealing with IP issues that their utilization reviews will be poor. Speaking as a review nurse for an insurance company, you can tell which hospitals have nurses who know UR and which ones have hospitals who have nurses that are overworked or don't care and hence bring in more denials. It may seem like a "cheap fix" to ball it all up but in the long run it may cost you.
Also my other question would be do you at your job use inter quail or Milliman? that will also help with decreasing denials for commercial companies as well as Medicare, Medicare replacement policies as well as Medicaid, I have been doing UR for 14 years. We use inter quail as well as EHR for patients who do not meet inpatient criteria. this will also help when you have RAC reviews as the Feds are trying to recoup money when patients are billed in the incorrect status