About this opportunity
CS&S STAFFING SOLUTIONS lists this Director of Case Management opportunity in houston, Texas. Review the employer’s description below for duties, qualifications and application requirements.
Job description
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Job Description
POSITION TITLE: Director of Case Management
POSITION LOCATION: Houston, Texas
POSITION SUMMARY:
Overall responsibility for hospital utilization performance improvement and operational management of the Case Management Department in order 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.
The individual's responsibilities include the following activities:
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 review processes are completed accurately and in compliance with CMS regulations and hospital policy
ensure timely and effective patient transition and planning to support efficient patient throughput
implement and monitor processes to prevent payer disputes
develop and provide physician education and feedback on hospital utilization
ensure compliance with state and federal regulations and TJC accreditation standards
other duties as assigned
POSITION REQUIREMENTS:
Required qualifications include an active Registered nurse license with at least two years acute hospital case management experience. MSN preferred. Accredited Case Manager (ACM) preferred. McKesson InterQual experience preferred. Five years acute hospital case management experience preferred. Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computer literacy. Business planning experience preferred.
Additional Information
All your information will be kept confidential according to EEO guidelines.
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Worksite address
houston, TX, 77246, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.