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Job description
Title: Director of Case Management
Location: Lawton, OK 73505
Must-Haves:
Minimum 5 years of experience in case management, discharge planning, and/or utilization review in an acute care setting.
Minimum 3 years of Director experience at an acute care facility.
RN compact or Oklahoma state license.
Nice-To-Haves: Certification in Case Management or Utilization Review.
Duties and Responsibilities: Oversight of the Facility's Case Management team to ensure compliance with standards of practice and regulatory requirements.
Develop and foster effective collaboration between Case Management Departments, Medical Staff, corporate and facility leaders.
Work closely with providers and internal/external physician advisors for utilization review and management activities.
Coordinate all UM Committee activities and ensure compliance with meeting frequency and documentation.
Collaborate with Revenue Cycle teams and participate in medical necessity audits and denials.
Participate in appeals processes and work collaboratively with vendors.
Analyze length of stay and readmissions data, incorporating measures to ensure goals are met.
Introduce evidence-based practices to improve case management and transitions.
Conduct regular staff meetings to review regulatory requirements and provide general training for staff.
Qualifications: A. Licensure/Certification/Registration: Oklahoma RN
Certification in Case Management or Utilization Review preferred.
B. Education: BSN preferred; Registered nurse is required.
Skills: Demonstrated leadership and complex organizational management skills.
Excellent problem-solving, team-building, and organizational skills.
Familiarity with Federal and State regulations related to case management discharge planning.
Knowledge of integrated discharge planning practices and resources.
Familiarity with RACs, MACs, and the Medicare appeals process.
Ability to work with Administration, Physicians, and staff in multiple settings.
Ability to compile reports, interpret data, and prepare/administer presentations.
Ability to interpret and apply InterQual criteria.
Experience: A minimum of 5 years of experience in case management, discharge planning, and/or utilization review in an inpatient acute care setting. Strong clinical background preferred.
Screening Questions: Tell me why this opportunity is a great fit for you?
Describe your leadership style?
Interview Steps: Initial screen from Danielle.
Recruiter will review and may screen the candidate or send directly to the hiring manager for an interview.
On-Site Panel Interview.
Thank you for your immediate attention to this matter.
Worksite address
lawton, OK, 73505, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.