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Detroit, MI Full Time Posted: Tuesday, 15 October 2019
POSITION TITLE: Multi-Site Director of Case Management


Opportunity to work for a world class teaching and research organization that is on the cutting edge of healthcare innovation. Oversees hospital utilization performance improvement and operational management of the site Case Management Departments 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. Responsibilities include the following activities: a) manages department operations to assure effective throughput and reimbursement for services provided, b) leads the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement, c) ensures medical necessity review processes are completed accurately and in compliance with CMS regulations and hospital policy, d) ensures timely and effective patient transition and planning to support efficient patient throughput, e) implements and monitors processes to prevent payer disputes, f) develops and provides physician education and feedback on hospital utilization, g) ensures compliance with state and federal regulations and TJC accreditation standards, and h) other duties as assigned.

Graduate from an accredited school of Nursing. Bachelor's degree in Nursing or other health-related field, or the equivalent combination of education and/or related experience. Master's degree in Nursing, Business Administration or Hospital Administration preferred.

Three to five years of acute hospital case management leadership experience. Five years acute hospital case management experience preferred. McKesson InterQual® experience preferred. Business planning experience preferred.

Detroit, MI, United States of America
Job Juncture
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10/15/2019 5:58:28 PM

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