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The individual in this position has overall responsibility for hospital utilization management, transition management and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services.
This position integrates national standards for case management scope of services including:
Responsibilities
The individual’s responsibilities include the following activities: a) manage department operations to assure effective throughput and reimbursement for services provided, b) lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement, c) ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and hospital policy, d) ensure timely and effective patient transition and planning to support efficient patient throughput, e) implement and monitor processes to prevent payer disputes, f) develop and provide physician education and feedback on hospital utilization, g) participate in management of post-acute provider network, h) ensure compliance with state and federal regulations and TJC accreditation standards, and i) other duties as assigned.
SKILLS AND CERTIFICATIONS *bold skills and certification are required
Bachelor degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work
MSN, MBA, MSW or MHA.
3 years of acute hospital case management or healthcare leadership experience.
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
Accredited Case Manager (ACM)
Salary commensurate with experience and education
Job Type: Full-time
Pay: $1.00 per hour
Benefits:
Application Question(s):
Ability to Relocate:
Work Location: In person
Full Time
$135k-181k (estimate)
03/04/2024
04/05/2024
The job skills required for CASE MANAGEMENT DIRECTOR (Health Care Nursing Management) include Case Management, Leadership, Planning, Coordination, Social Work, Utilization Management, etc. Having related job skills and expertise will give you an advantage when applying to be a CASE MANAGEMENT DIRECTOR (Health Care Nursing Management). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by CASE MANAGEMENT DIRECTOR (Health Care Nursing Management). Select any job title you are interested in and start to search job requirements.