RN MSN MBA MSW Or MHA- Case Management Director In Memphis TN

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Today we are seeking a RN Case Management Director for our client in Memphis TN.This individual in this position will have 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 the companys accreditation standards and hospital policy
Education provided to physicians patients families and caregivers

Responsibilities

The individuals 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 hospital utilization performance improvement

c) ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet 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) participate in management of postacute provider network

h) ensure compliance with state and federal regulations and the hospital accreditation standards and i) other duties as assigned.

Skills and Certifications note: bold skills and certification are required

Bachelor degree in Business Nursing or Health Care Administration for RN or Masters in Social Work

MSN MBA MSW or MHA.

3 years of acute hospital case management or healthcare leadership experience.

5 years of acute hospital case management leadership multisite experience.

Registered Nurse or LCSW/LMSW license. Must be currently licensed certified or registered to practice in TN

Accredited Case Manager (ACM)

Compensation

Base Salary USD $110000 to $165000

Fulltime

Benefits Full

Relocation Assistance Available Possible for ideal candidate

Commission Compensation No

Bonus Eligible No

Overtime Eligible No

Interview Travel Reimbursed No

Candidate Details

2 to 5 years experience

Seniority Level Director

Management Experience Required No

Minimum Education Bachelors Degree

Willingness to Travel Occasionally

Security Clearance Required: Yes

Visa Candidate Considered: No

Remote Work :

No