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Director of Case Management

Memphis

Job Description Job Description 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 [email protected] 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

[email protected]

https://www.HealthcareRecruitmentPartners.com

A member of the Sanford Rose Associates® network of offices

America's Best Professional Recruiting Firms | Forbes 2023

Top 10 U.S. Search Firm – Executive Search Review

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