Director Of Case Management

EXECUTIVE HUMAN RESOURCE SERVICE

Human Resources Consultants

POSITION:
Director of Case Management MED#393

JOB CATEGORY:
Healthcare / Medical / Health Nurse Leadership

INDUSTRY:
Healthcare / Medical / Health Nurse Leadership

LOCATION:
San Francisco / East Bay Area Northern CA
Relocation Expense Provided

SALARY: $180K $230K Based on Experience

BENEFITS:
Full Benefits Provided.

QUALIFICATIONS:
Although Individual are encouraged to apply the Ideal candidate with the following experience will only be considered.

Requirements for Director of Case Management

Education: Bachelor Degree in Business Nursing or Health Care Administration for RN or Masters in Social Work for MSW.

Preferred: MSN MBA MSW or MHA.

Experience: Three (3) years of acute hospital case management or healthcare leadership experience. Preferred Five (5) years of acute hospital case management leadership multisite experience

Certification: Registered Nurse or LCSW/LMSW license. Must be currently licensed certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN or LCSW/LMSW license for state(s) covered. Preferred: Accredited Case Manager (ACM)

SKILLS:
Skills and Abilities Required for Director of Case Management
Clinical Knowledge Patient Care Management Case Management Systems Data Analysis Budget Management Strategic Planning Program Development Process Improvement Leadership Training and Development Conflict Resolution Team Management Communication Organizational and Administrative Skills Regulatory Knowledge Compliance Quality Assurance Patient Advocacy

CAREER OPPORTUNITY:
Executive Human Resource Service a Certified Women Minority Owned Business Enterprise and a leading provider of comprehensive human resource solutions for organizations of all sizes. We provide staffing solutions to healthcare facilities across the United States. Our mission is to connect qualified and dedicated healthcare professionals with topnotch facilities to improve patient care and outcomes.

Executive Human Resource Service is privileged to present an exciting opportunity.

Career Opportunity For Director of Case Management
As the Director of Medical Case Management you will be responsible for leading and managing the case management department ensuring that patients receive the necessary care in a timely and costeffective manner.

This role involves developing and implementing case management programs supervising case management staff and collaborating with other healthcare providers to optimize patient outcomes.

The Director will ensure compliance with all relevant regulations and standards while working to improve the quality and efficiency of care delivery.

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 hospital policy

Responsibilities Include

The individuals responsibilities include the following activities:

• 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 hospital 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 postacute provider network

• Ensure compliance with state and federal regulations and TJC accreditation standards and other duties as assigned.

• Must be US Citizen or Authorized to Work in the United States

Thank you for taking the time to share this information with your business colleagues. Any inquiries will be held in the strictest confidence. I look forward to hearing from you soon.

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