We are looking for a Director of Case Management. In this position you will be responsible for the following:

• Leading and meeting the length of stay intitiatives and metrics.
• Frequent communication with hospitalists, intensivists, and community physicians regarding length of stay and discharge planning.
• Communication with nursing managers, etc length of stay, discharge planning and patient status.
• Manage bundled payment improvements.
• Perform concurrent daily review and audit of case management and discharge planning documentation.
• Assist in appeal process on any insurance denial when requested.
• Participate in education for Case Managers, Social Workers, nursing and medical staff regarding care coordination.

ducation and Work Experience

• Minimum 5 years post graduate of an accredited school of nursing and a currently state Registered Nurse license.
• Required to have a minimum of 5 years experience in a Case Management position.
• Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
• Certification in Case Management, BS or BSN or related field preferred.
• Current BCLS (AHA) certificate upon hire and maintain current.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Experience and knowledge in basic to intermediate computer skills.
• Current Behavioral Violence Prevention Training within 3 months of hire and maintain current.

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Job Type: Full-time

Benefits:

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

Schedule:

• Day shift

Work Location: In person