Senior Manager of Case Management Services

1 week ago


Modesto, California, United States Healthcare Recruitment Partners Full time
Position Overview

The Director of Case Management Operations plays a pivotal role in enhancing the effectiveness of Case Management within our organization. This leadership position is essential for the implementation of strategic initiatives that drive excellence in patient care.

Key Qualifications:

  • A minimum of a Bachelor's degree is required.
  • Must possess a valid Registered Nurse license.
  • Proven experience as a Director of Case Management in a hospital setting is essential.
  • Certification from ACMA or CCM is preferred.
  • A Bachelor's Degree in Nursing is advantageous.
  • Experience managing Case Management across multiple campuses is a plus.

Core Responsibilities:

  • Oversee the integration of national standards for Case Management services, including Utilization Management.
  • Facilitate medical necessity assessments and denial prevention strategies, while promoting effective transition management to enhance patient satisfaction and minimize readmissions.
  • Ensure efficient Care Coordination, maintaining the appropriate sequence and level of care.
  • Act as a key information resource, collaborating with various departments and external stakeholders.
  • Implement the strategic plan while providing expertise on Case Management regulations and standards.
  • Guarantee compliance with all relevant state and federal regulations.
  • Optimize resource utilization, ensuring timely and accurate revenue cycle processes, denial prevention, and effective patient throughput.

This role is crucial for those looking to advance their career in Case Management. We encourage interested candidates to explore our opportunities further.


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