Director of Case Management Operations
1 month ago
Sturdy Memorial Hospital seeks a seasoned Director of Case Management Operations to lead our Department of Case Management. As a key member of our clinical leadership team, you will be responsible for providing administrative leadership and strategic direction to our case management team.
Key Responsibilities:- Provide administrative leadership to the Department of Case Management, ensuring effective utilization of resources and maximizing access to care.
- Develop and implement strategic plans to improve patient outcomes, reduce length of stay, and enhance care transitions.
- Collaborate with interdisciplinary teams to ensure seamless care coordination and transitions.
- Chair the quarterly Utilization Review Committee, analyzing data on key metrics and preparing reports for stakeholders.
- Ensure compliance with Federal, State, and private payer guidelines, as well as Joint Commission standards and HIPAA regulations.
- Minimum of 3-5 years of progressively responsible experience in a Case Management leadership role.
- Expert knowledge of acute care Case Management, including medical necessity, utilization review, LOS management, readmission reduction, and denials management.
- Strong leadership and communication skills, with the ability to mentor and educate staff.
- Excellent analytical and problem-solving skills, with the ability to develop and implement quality improvement initiatives.
- Current knowledge of State and Federal regulations, Joint Commission standards, HIPAA regulations, and Medicare COP.
- Master's degree in Health Care Administration, Business Management, Nursing, or a related healthcare field.
- Ability to listen and receive feedback openly and effectively.
- Strong team approach, with the ability to collaborate across the care continuum.
- Ability to multi-task, prioritize, and manage workflow in a dynamic environment.
Sturdy Memorial Hospital is an equal employment opportunity employer. We value diversity and inclusion and are committed to creating a workplace that is welcoming and inclusive for all employees.
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Attleboro, Massachusetts, United States Sturdy Memorial Full timeJob SummarySturdy Memorial Hospital seeks a highly skilled and experienced Director of Case Management and Utilization Review to lead our team in providing exceptional patient care and ensuring compliance with regulatory requirements.Key ResponsibilitiesProvide administrative leadership to the Department of Case Management, overseeing Utilization Review,...
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