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Head of Case Management Services
2 months ago
Company: TechForcePros
Industry: Healthcare — Pharmaceuticals — Nursing — Home Health — Case Management
TechForcePros is a leading staffing and recruitment firm recognized for its outstanding capabilities in various essential sectors of healthcare. We pride ourselves on being a reliable partner in linking exceptional talent with prominent organizations.
Position: Director of Case Management
Compensation: $180,000 - $230,000
Classification: Full-Time
Role Summary:
The Director of Case Management is responsible for the strategic planning, organization, implementation, and oversight of care coordination initiatives within the Medical Center. This role involves providing comprehensive direction to case management functions, which encompass care coordination, utilization review, social services, and discharge planning.
Key Responsibilities:
- Oversee department operations to ensure effective service delivery and reimbursement.
- Lead the execution and management of the hospital's Utilization Management Plan, utilizing data to enhance hospital performance.
- Ensure compliance with medical necessity and revenue cycle processes according to regulatory standards.
- Facilitate timely patient transitions and planning to optimize throughput.
- Develop strategies to mitigate payer disputes.
- Provide education and feedback to physicians regarding hospital utilization practices.
- Engage in the management of the post-acute provider network.
Qualifications:
Required:
- Bachelor's degree in Business, Nursing, or Healthcare Administration for RN or a Master's in Social Work for MSW.
- Minimum of 3 years of experience in acute hospital case management or healthcare leadership.
- Active Registered Nurse or LCSW/LMSW license, compliant with state regulations.
Preferred:
- Master's degrees such as MSN, MBA, MSW, or MHA.
- 5 years of leadership experience in acute hospital case management across multiple sites.
- Accredited Case Manager (ACM) certification.
