Director of Case Management

Director of Case Management
Memphis, Tennessee

The Director of Case Management supports the advancement of Case Management. The Director of Case Management performs the functions necessary to support Case Management strategy. The Director of Case Management is responsible for hospital Utilization Management, Transition Management, and operational management of the Case Management Department. The Director of Case Management promotes 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.

Qualifications:

• Registered Nurse required
• Bachelor's Degree in Nursing of Bachelor's Degree in Healthcare required
• Master's Degree preferred
• Director of Case Management experience in an acute hospital setting
• Certified Case Management (CCM) or Accredited Case Manager (ACM) certification preferred

Responsibilities:

• 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
• Ensure timely and effective patient transition and planning to support efficient patient throughput
• Manage department operations to assure effective throughput and reimbursement for services provided
• 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

• 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
• Education provided to physicians, patients, families and caregivers

For our Case Management opportunities, feel free to forward a resume to Michelle Boeckmann at Michelle@HCRecruiter.com or visit our Case Management website at https://www.HealthcareRecruitmentPartners.com/Careers.

If this opportunity is of interest or know someone that would have interest, please feel free to contact me at your earliest convenience.

Michelle Boeckmann | President Case Management Recruitment
Direct Dial 615-465-0292 | Toll Free 800-940-2313 Ext 101
Michelle@HCRecruiter.com
https://www.HealthcareRecruitmentPartners.com

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