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Head of Case Management Operations

2 months ago

Detroit, Michigan, United States Orion Groups Full time

Orion Groups is a distinguished professional services firm located in McKinney, TX, dedicated to providing seasoned consultants to pivotal organizations throughout the United States. Our expertise lies in the financial and healthcare sectors, where we excel in technology solutions encompassing application development, enterprise software systems, data strategies, integration, and IT infrastructure. We are committed to understanding and delivering value tailored to your specific requirements.

POSITION SUMMARY

We are seeking a Director of Case Management to lead initiatives within a national healthcare system.

The Director will play a crucial role in enhancing and implementing the Case Management strategy, serving as a leader, mentor, and consultant.

KEY RESPONSIBILITIES

  • Drive the execution of the strategic plan while providing expert guidance on Case Management regulations and standards, ensuring adherence to all applicable state and federal laws.
  • Oversee the efficient use of resources, ensuring timely and precise revenue cycle operations, denial mitigation, and safe patient throughput.
  • Integrate national standards for Case Management services, focusing on utilization management that supports medical necessity, denial prevention, and patient satisfaction.
  • Facilitate care coordination by demonstrating efficiency in patient throughput while ensuring care is delivered in the correct sequence and at the appropriate level.
  • Act as a resource for information, collaborating with physicians, allied health professionals, corporate staff, finance teams, supply chain personnel, vendors, and other stakeholders.

QUALIFICATIONS

  • A minimum of 5 years of experience in hospital revenue cycle management.
  • At least 5 years of leadership experience in multi-site hospital Case Management.
  • Experience in business planning and project management.

EDUCATIONAL REQUIREMENTS

  • Registered Nurse or LCSW/LMSW license; or relevant experience as approved by the VP of Case Management; Accredited Case Manager (ACM) is preferred.
  • Bachelor's degree in Business, Nursing, or Healthcare Administration; a Master's degree is preferred.

Orion Groups is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by law.