Market Case Management Director

5 days ago

Gallatin Tennessee, United States AP Recruiters Full time

Job Summary:

The Market Director of Case Management will provide leadership and management for hospitals within the Client's market. This position will be responsible for the day-to-day operations, including directing and planning, formulating and implementing operational strategies and initiatives in the case management program.

Key Responsibilities:

  • Ensure staff competencies in all areas of care management, including utilization review, transition/discharge planning, and social work services.
  • Provide specialized expertise and ensure resource alignment with system-wide initiatives.
  • Update appropriate parties on case management strategies, initiatives, outcomes, and issues.
  • Successfully partner with physicians and others to ensure delivery of evidence-based care and reduction of avoidable clinical variation in care.
  • Collaborate with Hospital Executive Leadership, Nursing, Medical staff, and other department stakeholders to facilitate care in a safe environment.

Requirements:

  • Bachelor's degree in Nursing - Required
  • State of Tennessee or Multi-State Registered Nurse licensure - Required
  • Minimum four years management experience directing a Case Management Department in an acute care hospital
  • Working knowledge of Care Management department functions, including Joint Commission and Conditions of Participation (COP) requirements
  • Good understanding of Medicare, Medicaid, and other third-party payment systems

Preferred Qualifications:

  • BLS certification from the American Heart Association (AHA) or American Red Cross (ARC) - Required within 30 days of hire, if not current upon hire
  • Master's degree in Nursing, Healthcare Administration or Business Administration
  • Certification in Case Management such as CCM

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