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.

QUALIFICATIONS:

**** Bachelor’s degree in business, Nursing or Health Care for RN or master’s in social work for MSW.

**** Preferred: MSN, MBA, MSW or MHA.

**** Required: 3 years of acute hospital case management or healthcare leadership experience.

**** Preferred: 5 years of acute hospital case management leadership multi-site experience

Certification:

**** Required: Registered Nurse or LCSW/LMSW license.

**** Must be currently licensed, certified or registered to practice profession

**** Active RN or LCSW/LMSW license for state(s) covered.

**** Preferred: Accredited Case Manager (ACM)

Job Type: Full-time

Pay: $172,500.98 - $230,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Relocation assistance
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Supplemental pay types:

• Signing bonus

License/Certification:

• Clinical Social Worker (Preferred)
• Certified Case Manager (Preferred)
• RN (Preferred)
• Accredited Case Manager (ACM) (Preferred)

Ability to Commute:

• San Ramon, CA 94583 (Required)

Ability to Relocate:

• San Ramon, CA 94583: Relocate before starting work (Required)

Work Location: In person