Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ... Experience: 3 years of acute hospital case management or healthcare leadership experience
Director of Case Management
Memphis, TN · On-site
... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ... Experience: 3 years of acute hospital case management or healthcare leadership experience
Director of Case Management
Cordova, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Cordova, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Arlington, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Arlington, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director of Case Management
Memphis, TN · On-site
... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ... Experience: 3 years of acute hospital case management or healthcare leadership experience
Director of Case Management
Memphis, TN · On-site
... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ... Experience: 3 years of acute hospital case management or healthcare leadership experience
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
This position integrates national standards for case management scope of services including ... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ...
Director Case Management
Nashville, TN · On-site
$109K - $135K/yr
A Director of Case Management opportunity is available in Nashville, TN. This leadership role oversees all operational aspects of hospital case management, bringing executive-level direction to care ...
New
Quick apply
Director Case Management
Nashville, TN · On-site
$109K - $135K/yr
A Director of Case Management opportunity is available in Nashville, TN. This leadership role oversees all operational aspects of hospital case management, bringing executive-level direction to care ...
New
Director Case Management
Nashville, TN · On-site
$109.76K - $135K/yr
A Director of Case Management opportunity is available in Nashville, TN. This leadership role oversees all operational aspects of hospital case management, bringing executive-level direction to care ...
Quick apply
Director Case Management
Nashville, TN · On-site
$109.76K - $135K/yr
A Director of Case Management opportunity is available in Nashville, TN. This leadership role oversees all operational aspects of hospital case management, bringing executive-level direction to care ...
Director Case Management
Memphis, TN · On-site
$110K - $165K/yr
───── Director of Case Management - Full-Time ───── ┌─────┐ Location: Memphis, Tennessee Setting: Acute Care Hospital Employment Type: Full-Time Experience Level:
Quick apply
Director Case Management
Memphis, TN · On-site
$110K - $165K/yr
───── Director of Case Management - Full-Time ───── ┌─────┐ Location: Memphis, Tennessee Setting: Acute Care Hospital Employment Type: Full-Time Experience Level:
Introduction Do you want to join an organization that invests in you as a Director Case Management? At TriStar Skyline Medical Center, you come first. HCA Healthcare has committed up to $300 million ...
Introduction Do you want to join an organization that invests in you as a Director Case Management? At TriStar Skyline Medical Center, you come first. HCA Healthcare has committed up to $300 million ...
Director - Case Management
Nashville, TN · On-site
$109K - $135K/yr
Director - Case Management Location: Nashville, TN Salary: $109,000 - $135,000 + incentive bonus Bonus: Upto $10,000 Sign-On | Relocation (case-by-case) Shift: Full-Time, Days Job Summary Lead ...
Quick apply
Director - Case Management
Nashville, TN · On-site
$109K - $135K/yr
Director - Case Management Location: Nashville, TN Salary: $109,000 - $135,000 + incentive bonus Bonus: Upto $10,000 Sign-On | Relocation (case-by-case) Shift: Full-Time, Days Job Summary Lead ...
Introduction Do you want to join an organization that invests in you as a Director Case Management? At TriStar Skyline Medical Center, you come first. HCA Healthcare has committed up to $300 million ...
Introduction Do you want to join an organization that invests in you as a Director Case Management? At TriStar Skyline Medical Center, you come first. HCA Healthcare has committed up to $300 million ...
Director Aetna Case Management information
What are the key skills and qualifications needed to thrive as a Director of Aetna Case Management, and why are they important?
To succeed as a Director of Aetna Case Management, you typically need a bachelor's or master's degree in nursing or a related field, active RN licensure, and extensive experience in case management or care coordination. Familiarity with case management software, utilization review tools, and health plan systems such as Milliman or InterQual is essential. Outstanding leadership, strategic thinking, and effective communication skills set top performers apart in this role. These competencies are crucial for driving quality care outcomes, ensuring regulatory compliance, and leading teams in a complex managed care environment.
How does a Director of Aetna Case Management typically collaborate with clinical teams and other departments?
A Director of Aetna Case Management regularly works with interdisciplinary teams, including nurses, social workers, physicians, and administrative staff. They facilitate coordination between departments to ensure members receive comprehensive, timely care and to streamline case management processes. Effective communication and leadership are essential, as the director often leads meetings, sets care management strategies, and resolves complex cases that require input from multiple specialties. Collaboration also extends to working with external providers and vendors to optimize patient outcomes and resource utilization.
What does a Director of Aetna Case Management do?
A Director of Aetna Case Management oversees the case management operations within the organization, ensuring that patients receive appropriate, cost-effective care. They lead teams of case managers, develop and implement care coordination strategies, and ensure compliance with regulations and Aetna's policies. Their role involves collaborating with healthcare providers, monitoring program outcomes, and improving processes to enhance patient health and satisfaction. Additionally, they play a crucial part in managing budgets and aligning case management practices with organizational goals.
What is the difference between Director Aetna Case Management vs Case Manager Aetna?
| Aspect | Director Aetna Case Management | Case Manager Aetna |
|---|---|---|
| Credentials | Typically requires RN, BSN, or related certifications; leadership experience | RN or relevant healthcare certification; less emphasis on leadership |
| Work Environment | Oversees teams, manages programs, strategic planning | Direct patient interactions, care coordination, documentation |
| Employer & Industry Usage | Used in health insurance companies like Aetna for leadership roles | Common in healthcare settings and insurance companies for direct care roles |
The main difference between Director Aetna Case Management and Case Manager Aetna lies in scope and responsibilities. The director oversees teams and strategic initiatives, requiring leadership experience, while the case manager focuses on direct patient care and care coordination. Both roles are integral to Aetna's healthcare management but differ significantly in seniority and scope.
What are the most commonly searched types of Aetna Case Management jobs in Tennessee? The most popular types of Aetna Case Management jobs in Tennessee are:
What are popular job titles related to Director Aetna Case Management jobs in Tennessee? For Director Aetna Case Management jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Director Aetna Case Management jobs in Tennessee look for? The top searched job categories for Director Aetna Case Management jobs in Tennessee are:
What cities in Tennessee are hiring for Director Aetna Case Management jobs? Cities in Tennessee with the most Director Aetna Case Management job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 21 days ago
Tenet Healthcare rating
6.1
Based on 336 frontline employees who took The Breakroom Quiz
708th of 864 rated healthcare providers
Job description
Job Description
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 Tenet policy; and Education provided to physicians, patients, families, and caregivers.
Responsibilities
Qualifications
About Us
Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Saint Francis Hospital hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.
At Saint Francis Hospital, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
Note: Eligibility for benefits may vary by location and is determined by employment status
About the Team
Saint Francis Hospital-Memphis is a 479-bed full-service hospital located at 5959 Park Avenue in Memphis, TN.Offering a wide array of medical services, Saint Francis is noted for its many Centers of Excellence, including its Center for Surgical Weight Loss, Joint & Spine Center, Heart & Vascular Center, Chest Pain Emergency Center, and Surgical Services including its Center for Robotic Surgery, Diabetes Center, and Cancer Center.The hospital has been recognized for excellence of care by United Healthcare, CIGNA, Blue Cross/Blue Shield, and Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee Surgical, Family Practice, and Psychiatric Residents. The hospital is accredited by the Joint Commission on the Accreditation of Healthcare Organizations, the nations oldest and largest hospital accreditation agency. At Saint Francis Healthcare, you can grow your career skills and be a vital member of our team where we strive to be No. 1 in quality, safety and service excellence. Join our team!
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 Tenet policy; and Education provided to physicians, patients, families, and caregivers.
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 Tenet policy
- Ensure timely and effective patient transition and planning to support efficient patient throughput
- develop and provide physician education and feedback on hospital utilization
- other duties as assigned.
Qualifications
- Required:
- Education: Bachelor's degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW
- Experience: 3 years of acute hospital case management or healthcare leadership experience
- Licensure/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:
- Experience: 5 years of acute hospital case management leadership multi-site experience
- Education: MSN, MBA, MSW, or MHA
- Licensure/Certification: Accredited Case Manager (ACM)
About Us
Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Saint Francis Hospital hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.
At Saint Francis Hospital, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
- Medical, dental, vision, and life insurance
- 401(k) retirement savings plan with employer match
- Generous paid time off
- Career development and continuing education opportunities
- Health savings accounts, healthcare & dependent flexible spending accounts
- Employee Assistance program, Employee discount program
- Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance
Note: Eligibility for benefits may vary by location and is determined by employment status
About the Team
Saint Francis Hospital-Memphis is a 479-bed full-service hospital located at 5959 Park Avenue in Memphis, TN.Offering a wide array of medical services, Saint Francis is noted for its many Centers of Excellence, including its Center for Surgical Weight Loss, Joint & Spine Center, Heart & Vascular Center, Chest Pain Emergency Center, and Surgical Services including its Center for Robotic Surgery, Diabetes Center, and Cancer Center.The hospital has been recognized for excellence of care by United Healthcare, CIGNA, Blue Cross/Blue Shield, and Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee Surgical, Family Practice, and Psychiatric Residents. The hospital is accredited by the Joint Commission on the Accreditation of Healthcare Organizations, the nations oldest and largest hospital accreditation agency. At Saint Francis Healthcare, you can grow your career skills and be a vital member of our team where we strive to be No. 1 in quality, safety and service excellence. Join our team!
What Tenet Healthcare employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Tenet Healthcare
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Dallas, TX, US
Year founded
1969