Director of Case Management
3 weeks ago
**Title:**:Director of Case Management
**Status:**:Full-Time with client
**Location**: San Ramon, CA
**Pay Rate**: $68.58 - $109.71/hr
**Visa:**:No visa sponsorships supported
**Travel**: Occasionally
**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.
**_This position integrates national standards for case management scope of services including:_**:
- 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, TJC accreditation standards and hospital policy
- Education provided to physicians, patients, families and caregivers
**Responsibilities**:
- Manage department operations to assure effective throughput and reimbursement for services provided,
- Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement,
- Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and hospital policy,
- Ensure timely and effective patient transition and planning to support efficient patient throughput,
- Implement and monitor processes to prevent payer disputes,
- Develop and provide physician education and feedback on hospital utilization,
- Participate in management of post-acute provider network,
- Ensure compliance with state and federal regulations and TJC accreditation standards,
- Other duties as assigned.
**Required Qualifications**:
**Education**:
- Bachelor degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW.
- MSN, MBA, MSW or MHA (preferred)
**Experience**:
- 3 years of acute hospital case management or healthcare leadership experience required
- 5 years of acute hospital case management leadership multi-site experience (preferred)
- Business planning experience (preferred)
**Certification**:
- Required: Registered Nurse or LCSW/LMSW license. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN or LCSW/LMSW license for state(s) covered.
- Accredited Case Manager (ACM) (preferred)
**Required Skills**:
- Demonstrated organizational skills
- Excellent verbal and written communication skills
- Ability to lead and coordinate activities of a diverse group of people in a fast paced environment
- Critical thinking and problem solving skills and computer literacy
-
Director of Case Management
5 days ago
San Ramon, United States McCulloh Consulting Full timeAbout the job Director of Case Management Are you a Director of Case Management with a background in hospital revenue cycles? Do you possess one of the following licenses: RN LCSW or LMSW?? Do you want to live in the San Francisco Bay area and find out what all the buzz is about!? If so, keep reading about this amazing opportunity. Responsibilities: The...
-
Director of Case Management
6 days ago
San Ramon, United States McCulloh Consulting Full timeAbout the job Director of Case Management Are you a Director of Case Management with a background in hospital revenue cycles? Do you possess one of the following licenses: RN LCSW or LMSW?? Do you want to live in the San Francisco Bay area and find out what all the buzz is about!? If so, keep reading about this amazing opportunity. Responsibilities: The...
-
Director of Case Management
3 days ago
San Ramon, United States McCulloh Consulting Full timeJob DescriptionJob DescriptionAre you a Director of Case Management with a background in hospital revenue cycles? Do you possess one of the following licenses: RN LCSW or LMSW?? Do you want to live in the San Francisco Bay area and find out what all the buzz is about!? If so, keep reading about this amazing opportunity.Responsibilities:The Case Management...
-
Director - Case Management
1 week ago
San Ramon, United States Dotsher Inc. Full timeJob Title - Director - Case Management Location: San Ramon, California ( Relocation Assistance Available ) Industry: Healthcare / Health Services Job Category: Medical / Health - Nurse Leadership QUALIFICATIONS: Bachelor's degree in business, Nursing or Health Care for RN or master's in social work for MSW. Preferred: MSN, MBA, MSW or MHA. ...
-
Director - Case Management
2 weeks ago
San Ramon, United States Dotsher Inc. Full timeJob Title - Director - Case Management Location: San Ramon, California ( Relocation Assistance Available ) Industry: Healthcare / Health Services Job Category: Medical / Health - Nurse Leadership QUALIFICATIONS: Bachelor's degree in business, Nursing or Health Care for RN or master's in social work for MSW. Preferred: MSN, MBA, MSW or MHA. ...
-
Director - Case Management
2 weeks ago
San Ramon, United States Dotsher Inc. Full timeJob Title - Director - Case Management Location: San Ramon, California ( Relocation Assistance Available ) Industry: Healthcare / Health Services Job Category: Medical / Health - Nurse Leadership QUALIFICATIONS: Bachelor's degree in business, Nursing or Health Care for RN or master's in social work for MSW. Preferred: MSN, MBA, MSW or MHA. ...
-
Director - Case Management
3 weeks ago
San Ramon, United States Dotsher Inc. Full timeJob Title – Director - Case Management Location: San Ramon, California ( Relocation Assistance Available ) Industry: Healthcare / Health Services Job Category: Medical / Health – Nurse Leadership QUALIFICATIONS: · Bachelor’s degree in business, Nursing or Health Care for RN or master’s in social work for MSW. · ...
-
Director - Case Management
2 weeks ago
San Ramon, United States Dotsher Inc. Full timeJob Title – Director - Case Management Location: San Ramon, California ( Relocation Assistance Available ) Industry: Healthcare / Health Services Job Category: Medical / Health – Nurse Leadership QUALIFICATIONS: · Bachelor’s degree in business, Nursing or Health Care for RN or master’s in social work for MSW. · ...
-
Director of Case Management
2 weeks ago
San Ramon, United States ALOIS Healthcare Full timeJob Title: Director of Case ManagementLocation: San Ramon, CAPosition Type: PermanentSalary Up to $230,000 + BenefitsJob Description:Manage department operations to assure effective throughput and reimbursement for services provided,Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization...
-
Director of Case Management
2 weeks ago
San Ramon, United States ALOIS Healthcare Full timeJob Title: Director of Case ManagementLocation: San Ramon, CAPosition Type: PermanentSalary Up to $230,000 + BenefitsJob Description:Manage department operations to assure effective throughput and reimbursement for services provided,Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization...
-
Director of Case Management
2 weeks ago
San Ramon, United States ALOIS Healthcare Full timeJob Title: Director of Case ManagementLocation: San Ramon, CAPosition Type: PermanentSalary Up to $230,000 + BenefitsJob Description:Manage department operations to assure effective throughput and reimbursement for services provided,Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization...
-
Nurse Director, Case Management
3 weeks ago
San Ramon, United States Amtex Systems Inc Full timeJob DescriptionJob DescriptionJob Title Nurse Director, Case ManagementLocation: San Ramon, California ( Relocation Assistance Available )Industry: Healthcare / Health ServicesJob Category: Medical / Health Nurse LeadershipQUALIFICATIONS:**** Bachelor's degree in business, Nursing or Health Care for RN or master's in social work for MSW. ****...
-
Director of Case Management
3 weeks ago
San Ramon, United States Switch4 LLC Full time**Role**: Director of Case Management **Location**: San Ramon, California **Type**: FTE/Permanent **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,...
-
Director of Case Management
5 days ago
San Ramon, United States Switch4 LLC Full time**Role**: Director of Case Management **Location**: San Ramon, California **Type**: FTE/Permanent **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,...
-
Director of Case Management Full Time Days
3 weeks ago
San Ramon, United States HumanRek Trading Full time**Responsibilities** The 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...
-
Director of Case Management
2 weeks ago
San Ramon, United States Macpower Digital Assets Edge Private Limited (MDA Edge) Full timeJob 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...
-
Director of Case Management
2 weeks ago
San Ramon, United States Macpower Digital Assets Edge Full timeJob 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,...
-
Director of Case Management
3 weeks ago
San Ramon, United States Macpower Digital Assets Edge Private Limited (MDA Edge) Full timeJob 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,...
-
Director of Case Management
1 week ago
San Ramon, United States Macpower Digital Assets Edge Full timeJob 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,...
-
Director of Case Management Full Time Days
2 weeks ago
San Ramon, United States San Ramon Regional Medical Center Full time**San Ramon Regional Medical Center** San Ramon Regional Medical Center began serving residents of the San Ramon Valley and its surrounding communities in 1990. Located on a hillside overlooking the valley, we are a 123-bed, acute-care hospital, primary stroke center, and a cardiac heart surgery hospital. San Ramon Regional Medical Center provides...
