Role OverviewOversees hospital utilization performance improvement and operational management of the site Case Management Department to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.
What You Will Do
Manages department operations, leads the implementation and oversight of the hospital Utilization Management Plan, ensures medical necessity review processes are completed accurately and in compliance with CMS regulations and Tenet policy, and ensures timely and effective patient transition and planning to support efficient patient throughput.
Why It Might Be a Fit
Requires a results-driven leader with experience in acute hospital case management leadership, analytical and fiscal skills, strong communication and interpersonal skills, teaching abilities, project management skills, leadership skills, and technical knowledge of community resources, regulatory requirements, reimbursements, and utilization management procedures.
Requirements
- Bachelor’s degree in Nursing or other health-related field, or the equivalent combination of education and/or related experience or Master’s in Social Work for MSW
- Registered Nurse or LCSW/LMSW license
- Three to five years of acute hospital case management leadership experience
- Accredited Case Manager (ACM) preferred
Benefits
- Medical, dental, vision, and life insurance
- 401(k) retirement savings plan with employer match
- Generous paid time off (PTO)
- 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
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