Director, Case Management

1 week ago


Society Hill, United States Inteletech Global Inc Full time

Job DescriptionJob DescriptionCase Management, DirectorRock Hill, South CarolinaFull timeIndustry: Healthcare Case Management Job Description: Minimum Experience:Five to seven years of experience with utilization review, clinical pathways, case management, and disease management are required. Supervisory experience is preferred.Case Management ResponsibilitiesThe individual's responsibilities include the following activities:a) manage department operations to assure effective throughput and reimbursement for services provided,b) lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement,c)ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and the hospital's policy, d) ensure timely and effective patient transition and planning to support efficient patient throughput,e) implement and monitor processes to prevent payer disputes,f) develop and provide physician education and feedback on hospital utilization,g) participate in management of post-acute provider network,



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