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Director of Case Management Full Time Days
4 months ago
**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 medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and hospital 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,
h) ensure compliance with state and federal regulations and TJC accreditation standards and
i) other duties as assigned.
**Qualifications**
**Education:Required**:Bachelor's degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW
**Preferred**: MSN, MBA, MSW, or MHA
**Experience:Required**: 3 years of acute hospital case management or healthcare leadership experience
**Preferred**:5 years of acute hospital case management leadership multi-site experience
**Certifications: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.
**Preferred**:Accredited Case Manager (ACM)Physical Demands:Lift/position up to 25 lbs. Push/pull up to 25 lbs. of force. Frequent sitting. Moderate standing, walking, reaching, stooping, and bending. Manual dexterity, mobility, touch, auditory to perform all the related duties of the position.
Pay: $170,000.00 - $230,000.00 per year
**Benefits**:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Relocation assistance
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
Application Question(s):
**Experience**:
- Case Management: 5 years (required)
- Director of Case Management: 3 years (required)
License/Certification:
- Certified Case Manager (required)
- Active RN OR LCSW/LMSW license (required)
Ability to Relocate:
- San Ramon, CA 94583: Relocate before starting work (required)
Work Location: In person
