Director Of Case Management
Full-time
Company Description
Hospital
Job Description
Director Of Case Management
2+ to 5 years experience
The individual in this position has overall responsibility for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.
This position integrates national standards for case management scope of services including:
Utilization Management supporting medical necessity and denial prevention
Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
Compliance with state and federal regulatory requirements, TJC accreditation standards and our policy
Education provided to physicians, patients, families and caregivers
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 hospitals utilization performance improvement, c) ensure medical necessity review processes are completed accurately and in compliance with CMS regulations and our 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) ensure compliance with state and federal regulations and TJC accreditation standards, and h) other duties as assigned.
Qualifications
Required:
Active Registered Nurse License
At least two (2) years acute hospital case management leadership experience
Demonstrated organizational skills
Excellent verbal and written communication skills
Ability to lead and coordinate activities of a diverse group of people in a fast paced environment
Critical thinking and problem solving skills and computer literacy.
Additional Information
All your information will be kept confidential according to EEO guidelines. Direct Staffing Inc
DIRECTOR OF CASE MANAGEMENT in indio at Unknown Company
This position is listed as full time and onsite.