Director of Case Management
1 month ago
Summary:
The individual in this position has overall responsibility for hospital utilization management, transition management and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services.
Key Responsibilities:
• Utilization Management supporting medical necessity and denial prevention
• Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
• Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care.
• Compliance with state and federal regulatory requirements.
• Education provided to physicians, patients, families and caregivers.
Qualifications:
- Bachelor degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work.
- 3 years of acute hospital case management or healthcare leadership experience.
- 5 years of acute hospital case management leadership multi-site experience.
- Registered Nurse or LCSW/LMSW license
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