Nurse Director Case Management

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 and revenue cycle 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, participate in management of post-acute provider network, ensure compliance with state and federal regulations and TJC accreditation standards.

Requirements

Bachelor’s degree in business, Nursing or Health Care for RN or master’s in social work for MSW.   

Preferred: MSN, MBA, MSW or MHA.

Required: 3 years of acute hospital case management or healthcare leadership experience.  

Preferred: 5 years of acute hospital case management leadership multi-site experience

Certification:

Required: Registered Nurse or LCSW/LMSW license.

Must be currently licensed, certified or registered to practice profession

Active RN or LCSW/LMSW license for state(s) covered.

Preferred: Accredited Case Manager (ACM)

Benefits

401(k), with a 50% match up to 6% of pay, employee stock purchase plan, flexible spending accounts, retirement readiness tools, rollover support, and financial well-being counseling 

Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine

Wellbeing support, including employee assistance program (EAP) 

Time away from work programs for paid time off, long- and short-term plan coverage 

Education support through tuition assistance, student loan assistance, certification support, and online educational program 

Relocation Assistance Available