Director Case Management
Posted on :
20-09-2023
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Jobs by Experience
3-5years
Monthly Salary
Not Disclosed
Salary Not Disclosed
Posted on :
20-09-2023
Job Description
We are seeking a Director, Case Management to support a national healthcare network in San Antonio, TX.
This is an onsite role and relocation assistance is approved on a case-by-case basis by the company.
Job Summary:
This role will be responsible 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.
Key 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 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
Education:
- Bachelors degree in business, Nursing or Health Care Administration (required)
- MSN, MBA, MSW, or MHA (preferred)
Required:
- 3 years of acute hospital case management or healthcare leadership experience
- TX RN/Compact license or LCSW/LMSW license
Preferred:
- 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
An equal opportunity employer and we value diversity at our company. All aspects of employment are based on merit, performance, and business needs. We do not discriminate based upon race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
For more information about Hi-Quality Recruits, please visit
Required: 3 years of acute hospital case management or healthcare leadership experience TX RN/Compact license or LCSW/LMSW license Preferred: 5 years of acute hospital case management leadership multi-site experience Accredited Case Manager (ACM) McKesson InterQual experience Business Planning experience
Employment Type
Full Time
Key Skills
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