Director of Case Management

This position may qualify for a sign-on bonus.

About the role

Responsible 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.

This position integrates national standards for case management scope of services including:

• 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, patient, families and caregivers.

Completes established competencies for the position within designated introductory period. Other related duties as assigned.

Requirements

• Bachelor’s Degree from an accredited school, college or university as a Registered Nurse (required)
• Master’s Degree from an accredited college or university in Nursing or related field (preferred)
• 2 years in acute hospital case management, healthcare or leadership experiences (required)
• 5 years in acute hospital case management (preferred)
• McKesson InterQual® experience and Business Planning experience (preferred)
• Possession of current Texas State registration as a Registered Nurse (required)
• Accredited Case Management (ACM) certification (preferred)

Benefits

The available plans and programs include:

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program
• Employee discount program
• Voluntary benefits including pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status.