Group Director Case Management Lead
4 days ago
At Jamie Grayem, we are seeking a highly skilled and experienced Group Director Case Management to join our team. As a key member of our leadership team, you will be responsible for executing the hospital's organizational case management strategic plan across multiple hospitals.
Key Responsibilities:- Lead and facilitate group hospital Directors of Case Management performance for Level of Care, Length of Stay, and Payer Authorizations
- Establish goals and objectives that support overall strategic plans of the Case Management and Utilization Review strategy
- Lead Group hospital Case Management and Utilization Review operations for cost-effective and clinically sound care delivery
- Participate in new hospital Director of Case Management selection and lead the orientation and onboarding processes
- Maintain objectivity in decision making, utilizes facts to support decisions
- Anticipate and responds to problems and risks
- Communicate effectively with all levels in the organization and with internal / external customers
- Direct, support, and coach direct reports
- Develop experts and expertise throughout the department and seeks employee input
- Minimize staff turnover
- Lead implementation and monitoring of the hospital's Case Management policy and regulatory requirements
- Review weekly Case Management Scorecard Continuing Care (CC) and Utilization Review (UR) metrics, Observed / Expected Length of Stay, Authorizations and Downgrades
- Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement
- Manage department operations to ensure effective throughput and reimbursement for services provided
- Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and the hospital's 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
- Bachelor's degree in Business, Nursing, Social Work, or Health Care Administration
- 5 years of acute hospital case management leadership experience
- Registered Nurse or LCSW/LMSW license
- Active RN or LCSW/LMSW license for state(s) covered
- Accredited Case Manager (ACM) certification preferred
- Competitive salaries and benefits
- Matching 401(k) plan
- Several health & dental plans to choose from
- Generous tuition assistance plans
- Relocation assistance for select positions
We offer a comprehensive benefits package, including medical, prescription drug, dental, vision, behavioral health, and telemedicine services. We also provide wellbeing support, including an employee assistance program (EAP), time away from work programs, and savings and retirement plans.
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Modesto, California, United States Ekeo Group Full timeJob SummaryThe Group Director of Case Management is a key leadership position responsible for executing the hospital's case management strategic plan across multiple hospitals. This role requires a strong leader, mentor, consultant, and subject matter expert in case management regulations and standards.Key ResponsibilitiesLead and facilitate group hospital...
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Modesto, California, United States Jamie Grayem Full timeJob SummaryWe are seeking a highly experienced and skilled Group Director Case Management to lead our Case Management Department in Modesto, CA. As a key member of our leadership team, you will be responsible for executing the hospital's organizational case management strategic plan across multiple hospitals.Key ResponsibilitiesLead and facilitate group...
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Modesto, California, United States Jamie Grayem Full timeJob Title: Group Director Case ManagementAt Jamie Grayem, we are seeking a highly skilled and experienced Group Director Case Management to lead our Case Management Department. As a key member of our leadership team, you will be responsible for executing our organizational case management strategic plan across multiple hospitals.Key Responsibilities:Lead and...
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