Director Case Management

• 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 company 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 and
  
• Other duties as assigned.
  

Requirements

• Bachelors degree in business, Nursing or Health Care Administration (required)
  
• MSN, MBA, MSW, or MHA (preferred)
  

• 3 years of acute hospital case management or healthcare leadership experience
  
• TX RN/Compact license or LCSW/LMSW license

• 5 years of acute hospital case management leadership multi-site experience
  
• Accredited Case Manager (ACM)
  
• McKesson InterQual experience
  
• Business Planning experience
  

Benefits

• Health benefits
  
• PTO
  
• Holidays
  
• 401(k)
  
• And more