Current jobs related to Director of Case Management - Detroit - NPAworldwide

  • Healthcare Case Coordinator

    4 weeks ago

    Detroit, Michigan, United States Wellspring Case Management Full time

    Wellspring Case Management OverviewWellspring Case Management is committed to delivering empathetic care and advocacy for individuals impacted by motor vehicle incidents. As a reliable ally in the recovery process, we provide not only medical case management but also a profound source of support, optimism, and healing.Position: Healthcare Case CoordinatorWe...

  • Director of Case Management Operations

    2 weeks ago

    Detroit, Michigan, United States AP Recruiters Full time

    GROUP DIRECTOR OF CASE MANAGEMENTLocation: Detroit, MI (Relocation Assistance Provided)Job SummaryThe Group Director, Case Management will play a pivotal role in advancing the client's Case Management strategy. This leader will mentor and consult with teams to drive Case Management excellence.Develop and execute strategic plans to ensure compliance with...

  • Director of Case Management Operations

    2 weeks ago

    Detroit, Michigan, United States AP Recruiters Full time

    GROUP DIRECTOR OF CASE MANAGEMENTLocation: Detroit, MI (Relocation Assistance Provided)Job SummaryThe Group Director, Case Management will play a pivotal role in advancing the client's Case Management strategy. This leader will mentor and consult with teams to drive Case Management excellence.Execute on the strategic plan and provide subject matter expertise...

  • Group Director Case Management

    2 months ago

    Detroit, United States AP Recruiters Full time

    Job DescriptionJob DescriptionGROUP DIRECTOR OF CASE MANAGEMENTLocation: Detroit, MI (Relocation Assistance Provided)Job SummaryThe Group Director, Case Management will perform the functions necessary to support and advance the client's Case Management strategy. Will support the advancement of Case Management as a leader, mentor, and consultant. Will...

  • Director of Case Management Operations

    3 weeks ago

    Detroit, Michigan, United States AP Recruiters Full time

    Director of Case Management OperationsJob SummaryThe Director of Case Management Operations will play a key role in supporting and advancing the client's Case Management strategy. This individual will serve as a leader, mentor, and consultant to ensure the effective implementation of Case Management initiatives.Will execute on the strategic plan and provide...

  • Group Director Case Management

    3 weeks ago

    Detroit, United States AP Recruiters Full time

    GROUP DIRECTOR OF CASE MANAGEMENT Location: Detroit MI (Relocation Assistance Provided) Job Summary The Group Director Case Management will perform the functions necessary to support and advance the clients Case Management strategy. Will support the advancement of Case Management as a leader mentor and consultant. Will execute on the strategic plan and...

  • Case Management Director

    2 weeks ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryAs a seasoned healthcare professional, we are seeking a highly skilled and experienced Case Management Director to join our team at DMC Harper University/Hutzel Women's Hospital. This is an exciting opportunity to lead our Case Management and Social Work/Discharge Planning departments, working closely with hospital and system leadership to ensure...

  • Group Director Case Management Lead

    2 days ago

    Detroit, Michigan, United States Strivector Full time

    Job Title: Group Director Case ManagementStrivector is seeking a highly experienced Group Director Case Management to lead our hospital revenue cycle function. As a key member of our team, you will be responsible for executing our strategic plan and providing subject matter expertise on Case Management regulations and standards.Key Responsibilities:Ensure...

  • Director of Case Management Leadership

    2 weeks ago

    Detroit, Michigan, United States AP Recruiters Full time

    Job SummaryThe Director of Case Management Leadership will play a pivotal role in advancing the client's Case Management strategy. As a seasoned leader, mentor, and consultant, this individual will support the advancement of Case Management as a key business function.Key ResponsibilitiesExecute on the strategic plan for Case Management, ensuring compliance...

  • Case Management Director

    1 week ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryWe are seeking a highly skilled and experienced Case Management Manager to join our team at DMC Harper University/Hutzel Women's Hospital. As a key member of our healthcare team, you will be responsible for providing leadership and oversight to our Case Management and Social Work/Discharge Planning departments.Key ResponsibilitiesProvide...

  • Case Management Director

    2 weeks ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryAs a Case Management Manager at DMC Harper University/Hutzel Women's Hospital, you will be responsible for providing management and operational oversight for the Case Management and Social Work/Discharge Planning departments. This role requires collaboration with hospital and system leadership to ensure consistent and coordinated delivery of all...

  • Senior Manager of Case Management Operations

    1 month ago

    Detroit, Michigan, United States Resiliency LLC Full time

    Director of Case Management Services The Director of Case Management Services at Resiliency LLC plays a pivotal role in steering and enhancing the strategic objectives of the Case Management division. This position entails delivering guidance, mentorship, and advisory services to ensure adherence to regulations and standards, alongside the optimal use of...

  • Case Management Director

    2 weeks ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryDMC Harper University/Hutzel Women's Hospital seeks a skilled professional to oversee the Case Management and Social Work/Discharge Planning departments. The ideal candidate will possess strong leadership abilities, excellent communication skills, and a deep understanding of healthcare operations.Key ResponsibilitiesProvide management and...

  • Case Management Director

    2 weeks ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryDMC Harper University/Hutzel Women's Hospital seeks a seasoned professional to lead the Case Management and Social Work/Discharge Planning departments. As a key member of the hospital's leadership team, this individual will be responsible for ensuring the consistent and coordinated delivery of assigned processes.Key ResponsibilitiesManage...

  • Case Management Director

    2 weeks ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryDMC Harper University/Hutzel Women's Hospital seeks a seasoned professional to lead the Case Management and Social Work/Discharge Planning departments. As a key member of the hospital's leadership team, this individual will be responsible for ensuring the consistent and coordinated delivery of assigned processes.Key ResponsibilitiesManage...

  • Case Management Director

    2 weeks ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryAs a seasoned healthcare professional, you will oversee the management and operational oversight for the Case Management and Social Work/Discharge Planning departments at DMC Harper University/Hutzel Women's Hospital. This role requires collaboration with hospital and system leadership to ensure consistent and coordinated delivery of all assigned...

  • Case Management Director

    1 week ago

    Detroit, Michigan, United States DMC Harper UniversityHutzel Women's Hospital Full time

    Job SummaryDMC Harper University/Hutzel Women's Hospital seeks a seasoned professional to provide management and operational oversight for the Case Management and Social Work/Discharge Planning departments. The ideal candidate will collaborate with hospital and system leadership to ensure consistent and coordinated delivery of processes within the...

  • Lead Case Manager

    3 months ago

    Detroit, United States Neighborhood Service Organization Full time

    Job DescriptionJob DescriptionJob Title: Lead Case ManagerDepartment: IDD Pillar: WellbeingReports To: Program DirectorFLSA Status: ExemptSummary: The Lead Case Manager will carry a reduced case load and is responsible for the supervision of the Case Managers. Additionally, the Case Manager Lead will work with the Program Director to assure compliance with...

  • Head of Case Management Strategy

    1 month ago

    Detroit, Michigan, United States Resiliency LLC Full time

    Director of Case Management Operations The Director of Case Management Operations plays a pivotal role in steering and enhancing the strategic objectives of the Case Management division at Resiliency LLC. This position entails delivering guidance, mentorship, and advisory services to ensure adherence to regulations and standards, alongside the effective...

  • Head of Case Management Operations

    1 month ago

    Detroit, Michigan, United States Orion Groups Full time

    Orion Groups is a distinguished professional services firm located in McKinney, TX, dedicated to providing seasoned consultants to pivotal organizations throughout the United States. Our expertise lies in the financial and healthcare sectors, where we excel in technology solutions encompassing application development, enterprise software systems, data...

Director of Case Management

4 months ago

Detroit, United States NPAworldwide Full time
DIRECTOR CASE MANAGEMENT -
  • Full-time
  • DAYS
  • Direct Hire
  • Competitive Compensation, based on experience.
  • Benefits Package
  • Relocation Assistance Available - Possible
  • Location: Detroit, Michigan.
POSITION SPECIFIC RESPONSIBILITIES:
  • Department Operations
• Maintains an adequate number and skill mix over seven days a week to serve the patient population and meet the goals of the department

• Implements and supports with business case staffing requests utilizing the Case Management staffing recommendations and hospital budgetary guidelines

• Holds regular departmental meetings with staff to provide updates and provides for ongoing education

• Completes initial and annual competency and evaluation review on all case management staff

• Follows the InterQual Inter-rater Reliability (IRR) Policy to determine initial and yearly competency for all employees performing InterQual reviews

• Develops action plan for case managers that fail to meet the IRR acceptable "match" rate to ensure improvement in the accurate application of InterQual criteria
  • Utilization Management
  • Implements and monitors processes to ensure medical necessity review processes are in place for patients to be in the appropriate status and level of care per policy.
  • Oversees submission of cases to Physician Advisor review to ensure timely referral, follow up and documentation.
  • Implements and monitors utilization review process in place to communicate appropriate clinical data to payers to support admission, level of care, length of stay and authorization for post-acute services.
• Advocates for the patient and hospital with payers to secure appropriate payment for services rendered

• Implements and monitors physician "peer to peer" review process with payers to resolve denials or downgrades concurrently.
  • Transition Management
• Implements and monitors process to ensure that a transition plan assessment is completed within 24 hours of patient admission to identify and document the anticipated transition plan for patients

• Ensures case management staff use electronic referral request process for patient placements

• Monitors to ensure that patient choice is documented.
  • Care Coordination
• Works with Nursing and hospital leadership to ensure Patient Care Conferences and Complex Case Review processes are in place to promote timely and appropriate throughput

• Participates in daily bed management meeting to support timely and effective patient placement and transfer within the hospital

• Monitors to ensures that patients have a plan of care that is clinically appropriate, consistent with patient choice and available resources

• Monitors to ensures consults, testing and procedures are sequenced to support clinical needs with timely and efficient care delivery

• Ensures patient needs are communicated and that the healthcare team is mutually accountable to achieve the patient plan of care

• Effectively collaborates with physicians, nurses, ancillary staff, payors, patients and families to achieve optimum clinical outcomes
  • Education
• Provides education to physicians regarding medical necessity, complete and accurate documentation, and compliance with related regulatory requirements

• Prepares and provides data to physicians and the hospital on utilization of resources

• Provides education to case management staff, physicians and the healthcare team.
  • Compliance
• Ensures compliance with federal, state, and local regulations and accreditation requirements impacting case management scope of services

• Ensures that the department structure and staffing, policies and procedures to comply with policies

• Operates within the RN scope of practice as defined by state licensing regulations
  • Minimum Qualifications
1. Graduate from an accredited school of Nursing. Bachelor's degree in Nursing or other health-related field, or the equivalent combination of education and/or related experience. Master's degree in Nursing, Business Administration or Hospital Administration preferred.

2. Licensed to practice as a Registered Nurse in the State of Michigan;

3. Three to five years of acute hospital case management leadership experience. Five years acute hospital case management experience preferred. McKesson InterQual® experience preferred. Business planning experience preferred.

4. Accredited Case Manager (ACM) preferred.
  • Skills Required

1. Analytical ability to serve in an advisory/consultative role in determining and/or developing strategies, policies, processes, protocols and methods, frequently in the absence of guidelines or technical assistance, and to evaluate and direct complex systems that foster innovative approaches to procedures/processes.

2. Fiscal skills to monitor and control costs and revenue.

3. Ability to cope with stressful situations, manage multiple and sometimes conflicting priorities simultaneously.

4. Strong communication and interpersonal skills for frequent contacts with internal customers as well as stakeholders external to the DMC to persuade or negotiate on a wide range of subjects in situations which may be controversial, sensitive and/or lead to confrontation. A mastery of a variety of communication modalities is required to include leading meetings, making formal presentations, and writing complex documents and managing complex relationships over time.

5. Teaching abilities to conduct educational programs for staff.

6. Project management skills including the ability to define program, project, or process objectives, identify stakeholders and their interests, plan steps, coordinate and allocate human, technological and fiscal resources to accomplish goals and objectives in a resourceful yet timely manner.

7. Leadership skills including demonstrated willingness to pursue leadership roles with increasing levels of accountability, comfort with decision-making responsibilities, coaching, teaching and counseling skills, and the ability to inspire and build confidence in others and to forge alliances and garner support.

8. Technical knowledge of community resources, regulatory requirements, reimbursements and utilization management procedures in order to function as a resource for staff.

Security Clearance Required: No

Visa Candidate Considered: No