About this opportunity
MIT RESOURCE lists this Director of Case management permanent position at Lakewood CA opportunity in lakewood, California. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Director of Case management permanent position at Lakewood CA
Full-time
Title: Director of Case management
Location: Lakewood, CA
Type: Permanent
The individual in this position has 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.
Scope of Services
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
Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
Education provided to physicians, patients, families and caregivers
Job responsibilities
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 Tenet 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
Required Qualifications
5 years acute care experience
Two years acute hospital case management leadership
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
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Worksite address
lakewood, CA, 90715, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.