Head of Case Management Operations
2 weeks ago
Position: Director of Case Management
Location: San Ramon, CA
Compensation: $185K - $240K + Signing Bonus + Performance Bonus + Paid Relocation
Benefits Overview:
We provide a comprehensive benefits package that includes competitive salaries, matching 401(k), multiple health and dental plans, generous tuition assistance, and relocation support for select roles.
Our benefits encompass:
- Medical, prescription drug, dental, vision, behavioral health, and telemedicine services
- Wellbeing initiatives, including an employee assistance program (EAP)
- Paid time off and various time away from work programs
- Retirement savings options, including a 401(k) Plan with a 50% match up to 6% of pay, employee stock purchase plan, and financial counseling
- Educational support through tuition and student loan assistance
- Additional perks such as life insurance, supplemental health plans, auto and home insurance, legal support, identity theft protection, and employee discounts
Position Summary:
The Director of Case Management is responsible for overseeing hospital utilization management, transition management, and the operational management of the Case Management Department. This role is crucial for ensuring effective use of hospital resources, maintaining accurate revenue cycle processes, preventing denials, and ensuring compliance with relevant regulations.
Key Responsibilities:
- Manage departmental operations to ensure effective service delivery and reimbursement
- Lead the implementation of the hospital's Utilization Management Plan, utilizing data to enhance performance
- Ensure compliance with medical necessity and revenue cycle processes in accordance with regulations
- Facilitate timely patient transitions to support efficient throughput
- Develop and implement strategies to prevent payer disputes
- Provide education and feedback to physicians regarding hospital utilization
- Participate in the management of the post-acute provider network
- Ensure adherence to state and federal regulations and accreditation standards
- Perform additional 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: Minimum of 3 years in acute hospital case management or healthcare leadership.
Preferred: 5 years of leadership experience in multi-site acute hospital case management.
Licensure:
Required: Active Registered Nurse or LCSW/LMSW license.
Preferred: Accredited Case Manager (ACM).
Skills:
Demonstrated organizational abilities, strong verbal and written communication skills, capacity to lead diverse teams in a dynamic environment, critical thinking, problem-solving skills, and proficiency in computer applications.
Job Type: Full-time
Compensation:
Annual Salary: $185,000 - $240,000
Benefits Include:
- 401(k) with matching
- Dental and health insurance
- Employee assistance program
- Flexible spending account
- Life insurance
- Paid time off
- Relocation assistance
- Tuition reimbursement
- Vision insurance
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