Case Management Director

4 days ago

Memphis, Tennessee, United States Veracity Full time
Job Title: Case Management Director

About the Role:
The Case Management Director is responsible for overseeing the hospital's utilization management, transition management, and operational management of the Case Management Department. This role requires a strong understanding of hospital resources, revenue cycle processes, and regulatory requirements.

Key Responsibilities:
• Manage department operations to ensure 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 Tenet 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

Requirements:
• Bachelor's degree in Business, Nursing, or Healthcare Administration
• 3 years of acute hospital case management or healthcare leadership experience
• Registered Nurse or LCSW/LMSW license
• Accredited Case Manager (ACM) certification

What We Offer:
Veracity is committed to providing a supportive and challenging work environment that fosters professional growth and development. We offer competitive compensation and benefits packages, as well as opportunities for professional development and advancement.

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