Head of Case Management Operations
2 weeks ago
Position Overview: The individual in this role will be responsible for overseeing hospital resource utilization, managing transitions, and ensuring the operational efficiency of the Case Management Department. This position is crucial for optimizing hospital resources, facilitating timely revenue cycle processes, preventing denials, ensuring safe patient throughput, and maintaining compliance with all relevant state and federal regulations regarding case management services.
Key Responsibilities:
Utilization Management:
Support medical necessity assessments and denial prevention strategies.
Transition Management:
Encourage appropriate lengths of stay, prevent readmissions, and enhance patient satisfaction.
Care Coordination:
Ensure efficient patient throughput while guaranteeing that care is delivered in the correct order and at the appropriate level.
Compliance:
Adhere to state and federal regulatory standards, TJC accreditation requirements, and hospital policies.
Education:
Provide training and resources to physicians, patients, families, and caregivers.
Operational Responsibilities:
Oversee department operations to ensure effective patient throughput and reimbursement for services rendered.
Lead the execution and supervision of the hospital's Utilization Management Plan, utilizing data to enhance performance.
Ensure that medical necessity and revenue cycle processes are executed accurately and in compliance with CMS regulations and hospital policies.
Facilitate timely and effective patient transitions and planning to support efficient patient throughput.
Implement and monitor strategies to mitigate payer disputes.
Develop and deliver educational resources and feedback to physicians regarding hospital utilization.
Engage in the management of the post-acute provider network.
Ensure adherence to state and federal regulations and TJC 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: 3 years of experience in acute hospital case management or healthcare leadership.
Preferred: 5 years of leadership experience in acute hospital case management across multiple sites.
Certifications:
Required: Active Registered Nurse or LCSW/LMSW license. Must be licensed, certified, or registered to practice as required by law or regulation in the state of practice. Active RN or LCSW/LMSW license for applicable states.
Preferred: Accredited Case Manager (ACM).
Skills:
Demonstrated organizational abilities.
Excellent verbal and written communication skills.
Ability to lead and coordinate activities among a diverse group in a dynamic environment.
Strong critical thinking and problem-solving capabilities.
Proficient in computer applications.
Experience in business planning is preferred.
-
Head of Case Management Services
2 weeks ago
San Ramon, California, United States Veracity Full timeHead of Case Management Services Company: Veracity The individual in this role will oversee the comprehensive management of hospital resource utilization, transition processes, and operational leadership of the Case Management Department. The primary goal is to ensure effective use of hospital resources, maintain accurate revenue cycle operations, prevent...
-
Head of Case Management Operations
1 week ago
San Ramon, California, United States Knowhirematch Full timeJob OverviewPosition Title: Director Case ManagementLocation: San Ramon, CACompensation: $185K - $240K + Signing Bonus + Performance Bonus + Paid RelocationBenefits Overview:We provide competitive compensation packages along with a variety of benefits, including a matching 401(k) plan, multiple health and dental insurance options, generous tuition...
-
Head of Case Management Operations
2 weeks ago
San Ramon, California, United States Knowhirematch Full timeJob OverviewPosition: Director of Case ManagementLocation: San Ramon, CACompensation: $185K - $240K + Signing Bonus + Performance Bonus + Paid RelocationBenefits 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...
-
Head of Case Management Operations
2 weeks ago
San Ramon, California, United States Knowhirematch Full timeJob OverviewPosition Title: Director Case ManagementLocation: San Ramon, CACompensation: $185K - $240K + Signing Bonus + Performance Bonus + Paid RelocationBenefits Overview:We provide a comprehensive compensation package that includes competitive salaries, matching 401(k) plans, and a variety of health and dental insurance options. Additional benefits...
-
Head of Case Management Services
2 weeks ago
San Ramon, California, United States Norconsulting Global Recruitment Full timePOSITION OVERVIEW:Director of Case Management - Full Time, Day ShiftThe individual in this role is accountable for the comprehensive management of hospital utilization, transition processes, and the operational oversight of the Case Management Department. This position is crucial in ensuring the effective use of hospital resources, facilitating timely and...
-
Head of Case Management Services
2 weeks ago
San Ramon, California, United States Norconsulting Global Recruitment Full timePOSITION SUMMARY:Director of Case Management - Full Time, Day ShiftThe individual appointed to this role will hold comprehensive accountability for the management of hospital utilization, transitions, and the operational oversight of the Case Management Department. The primary objective is to ensure the effective use of hospital resources, facilitate timely...
-
Head of Case Management Services
2 weeks ago
San Ramon, California, United States Crescent City Recruitment Group Full timeDirector of Patient Care Coordination Location: San Ramon, CA Compensation: $185K - $240K + Signing Bonus + Performance Bonus + Paid Relocation Job Overview: Crescent City Recruitment Group is seeking a dedicated professional to oversee the Case Management Department, ensuring optimal utilization of hospital resources and compliance with regulatory...
-
Head of Case Management Services
1 week ago
San Ramon, California, United States TechForcePros Full timeJob OverviewCompany: TechForceProsIndustry: Healthcare — Pharmaceuticals — Nursing — Home Health — Case ManagementTechForcePros is a leading staffing and recruitment firm recognized for its specialized knowledge across vital healthcare sectors. We excel in connecting highly skilled professionals with esteemed organizations.Position: Director of Case...
-
Head of Case Management Services
1 week ago
San Ramon, California, United States TechForcePros Full timeJob OverviewCompany: TechForceProsIndustry: Healthcare — Pharmaceuticals — Nursing — Home Health — Case ManagementTechForcePros is a leading staffing and recruitment firm recognized for its outstanding capabilities in various essential sectors of healthcare. We pride ourselves on being a reliable partner in linking exceptional talent with prominent...
-
Head of Case Management Services
1 week ago
San Ramon, California, United States TechForcePros Full timeJob OverviewCompany: TechForceProsIndustry: Healthcare ServicesPosition: Director of Case ManagementCompensation: $180,000 - $230,000Location: RemoteClassification: Full-TimeRole Summary:The Director of Case Management is responsible for overseeing and directing care coordination initiatives within the organization. This role involves the strategic planning,...
-
Head of Case Management Services
1 week ago
San Ramon, California, United States Dayfoxx Resources Full timeDayfoxx Resources is a premier staffing and recruiting firm focused on the healthcare industry. We specialize in connecting exceptional talent with leading healthcare organizations.Position: Director of Case ManagementSalary Range: $180,000 - $230,000Employment Type: Full-TimeRole Overview:Oversee the planning, organization, and execution of care...
-
Chief of Case Management Operations
1 week ago
San Ramon, California, United States Dayfoxx Resources Full timeDayfoxx Resources is a premier staffing and recruiting firm dedicated to the healthcare industry. We specialize in connecting exceptional talent with leading healthcare organizations.Position: Director, Case ManagementSalary Range: $180,000 - $230,000Employment Type: Full-TimeRole Overview:Oversee the planning, organization, and execution of care...
-
Head of Educational Leadership
7 days ago
San Ramon, California, United States MAGNET SCHOOLS OF AMERICA Full timeAbout the RoleMagnet Schools of America is seeking a seasoned leader to join our team as Head of School (Director) to oversee the educational operations of our new school in the San Ramon, CA area.We are a community of educators driven by a deep desire to bring about widespread change in education today. We believe that the traditional method of education...
-
Travel Nurse RN Case Manager
22 hours ago
San Francisco, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerJob Type: Travel NursingLocation: NationwideJob Description:TotalMed Case Management Staffing is seeking a skilled Travel Nurse RN Case Manager to join our team. As a Travel Nurse RN Case Manager, you will be responsible for providing high-quality patient care and case management services to patients in various...
-
Travel Nurse RN Case Manager
5 days ago
San Francisco, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerJob Type: Travel NursingLocation: NationwideJob Description:TotalMed Case Management Staffing is seeking a skilled Travel Nurse RN Case Manager to join our team. As a Travel Nurse RN Case Manager, you will be responsible for providing high-quality patient care and managing cases in a fast-paced healthcare...
-
Clinical Operations Manager
7 days ago
San Francisco, California, United States Clinical Management Consultants Full timeJob Summary: Clinical Management Consultants is seeking an experienced Nurse Manager to oversee our Case Management team. As a key member of our clinical operations team, you will be responsible for supervising and supporting case managers, developing patient care plans, coordinating discharge planning, and improving healthcare delivery.Key...
-
Travel Nurse RN Case Manager
3 days ago
San Francisco, California, United States TotalMed Case Management Staffing Full timeWe are seeking a skilled Registered Nurse to join our team at TotalMed Case Management Staffing as a Case Manager. This is a travel nursing opportunity that requires a strong background in case management and a passion for delivering high-quality patient care.Job Summary:As a Case Manager, you will be responsible for coordinating patient care and services to...
-
Case Management RN Manager
2 weeks ago
San Ramon, California, United States NCH Healthcare System Full timeDEPARTMENT: NCH Case ManagementLOCATION: Naples, FLWORK TYPE: Full TimeWORK SCHEDULE: 8 Hour DayABOUT NCH HEALTHCARE SYSTEMNCH Healthcare System is a locally governed, independent non-profit organization dedicated to providing exceptional comprehensive healthcare services. Our system includes two hospitals, a network of over 700 physicians, and numerous...
-
Director of Case Management
4 days ago
San Ramon, California, United States Executive Human Resource Service Full timeJob SummaryWe are seeking a highly skilled and experienced Director of Case Management to join our team at Executive Human Resource Service. As a key member of our healthcare team, you will be responsible for leading and managing the case management department to ensure that patients receive the necessary care in a timely and cost-effective manner.Key...
-
Case Management Supervisor
2 weeks ago
San Ramon, California, United States NCH Healthcare System Full timeDEPARTMENT: NCH Case ManagementLOCATION: Naples, FLWORK TYPE: Full TimeWORK SCHEDULE: 8 Hour DayABOUT NCH HEALTHCARE SYSTEMNCH Healthcare System is a non-profit organization dedicated to providing exceptional healthcare services. Our system includes multiple hospitals, a network of over 700 physicians, and various medical facilities across Southwest Florida,...
