PostJobMatches By WorkStaff USA
PostJobMatches By WorkStaff USA is a leading staffing agency in the job placement industry, providing top-notch professionals to facilities across the country. Our team of experienced recruiters work together to match the best candidates with the right job opportunities.
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 company’s 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 post-acute 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 Master’s 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 multi-site 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 $110,000 to $165,000
Full-time
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 – Bachelor’s Degree
Willingness to Travel – Occasionally
Security Clearance Required: Yes
Visa Candidate Considered: No