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Director of Case Management
4 weeks ago
PostJobMatches By WorkStaff USA is seeking a highly skilled Director of Case Management to join our team. As a key member of our healthcare operations team, you will be responsible for leading the implementation and oversight of our hospital's Utilization Management Plan, ensuring effective throughput and reimbursement for services provided.
Key Responsibilities:
- Manage department operations to assure 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 hospital 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 Health Care Administration for RN or Master's in Social Work for MSW
- 3 years of acute hospital case management or healthcare leadership experience
- Preferred: 5 years of acute hospital case management leadership multi-site experience
- Registered Nurse or LCSW/LMSW license. Must be currently licensed, certified, or registered to practice profession as required by law or regulation in state of practice or policy. Active RN or LCSW/LMSW license for state(s) covered
Compensation:
- Base Salary - USD $180,000 to $230,000
- Full-time
- Benefits - Full
- Relocation Assistance Available - Possible for ideal candidate
- Commission Compensation - No
- Bonus Eligible - No
- Overtime Eligible - No
- Interview Travel Reimbursed No
