Director of Case Management

    Published
    February 1, 2024
    Location
    Southwest, Oklahoma
    State
    Oklahoma
    Region
    Southwest

    Description

    We are searching for a Director of Case Management for a hospital located in Southwestern Oklahoma

    **Ask about our Unlimited PTO for Directors & Red-Carpet Relocation Package

    Must-Haves

    Minimum 5 years of experience in case management, discharge planning and/or utilization review in an acute care setting.

    Minimum 3years of Director experience at an acute care facility

    RN compact or Oklahoma state license

    Nice-To-Haves

    Certification in Case Management or Utilization Review

    **Ask about our Unlimited PTO for Directors & Red Carpet Relocation Package

    Duties and Responsibilities

    • Oversight of the Facility’s Case Management team to ensure compliance with standards of practice and other regulatory requirements related to care management and utilization review.

    • Develop and foster effective collaboration between Case Management Departments, Medical Staff, corporate and facility leaders to ensure an integrated approach to providing care while fulfilling the hospital's goals and objectives.

    • Display an ability to work effectively within the health system's decision making and organizational structures.

    • Work closely with providers as well as internal and external physician advisors for utilization review and management activities

    • Coordinate all UM Committee activities to ensure compliance with meeting frequency and documentation of activity and outcomes

    • Work collaboratively with Revenue Cycle teams and participates in task force meetings related to medical necessity audits and denials.

    • Participate in appeals processes and work collaboratively with vendors to ensure the effectiveness and timeliness of appeals

    • Analyze length of stay and readmissions data and incorporate measures with Operations team members, Corporate Case Management Directors and other facility leaders to ensure goals are met

    • Introduce evidenced based practices geared to improve case management and transitions

    • Conduct regular staff meetings to review pertinent Federal and State regulatory requirements, emerging internal and external trends, and provide general training for staff

    Qualifications

    A. Licensure/Certification/Registration:

    Applicants with the following licensure may be considered: Oklahoma RN

    Certification in Case Management or Utilization Review is preferred

    B. Education: BSN preferred, Registered nurse is required.

    Skills

    • Demonstrated leadership and complex organizational management skills

    • Excellent management, problem solving, team building & organizational skills

    • Familiarity with Federal & State regulations related to case management discharge planning.

    • Knowledge of integrated discharge planning practices and resources available to patients

    • Demonstrated knowledge of RACs, MACs and the Medicare appeals process

    • Ability to work with Administration, Physicians, and staff in multiple settings

    • Ability to compile reports and interpret data

    • Ability to prepare and administer presentations

    Ability to interpret and apply InterQual criteria

    Experience: A minimum of 5 years’ experience in case management, discharge planning, and/or utilization review in an inpatient acute care setting. Strong clinical background is preferred.

    Benefits

    DENTAL INSURANCE

    MEDICAL INSURANCE

    VISION INSURANCE

    LIFE INSURANCE

    RETIREMENT

    EQUITY

    PAID TIME OFF

    LP

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