OPEN JOB: Director Case Management LOCATION: Memphis, Tennessee ***Relocation Assistance Available BASE SALARY: $110,000 to $165,000
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: 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 Tenet policy; and Education provided to physicians, patients, families, and caregivers.
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 Tenet policy
Ensure timely and effective patient transition and planning to support efficient patient throughput
develop and provide physician education and feedback on hospital utilization
other duties as assigned.
Qualifications
Required:
Education: Bachelor's degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW
Experience: 3 years of acute hospital case management or healthcare leadership experience
Licensure/Certification:
Registered Nurse or LCSW/LMSW license.
Preferred:
Experience: 5 years of acute hospital case management leadership multi-site experience
Education: MSN, MBA, MSW, or MHA
Licensure/Certification: Accredited Case Manager (ACM)
If you are interested in pursuing this opportunity, please respond back and include the following:
MS WORD Resume
required compensation.
Contact information.
Availability
Upon receipt, one of our managers will contact you to discuss the position in full detail.