Director of Case Management

Location

Lawton, OK | United States

Job description

Title: Director of Case Management
Shift: Full-Time 
Location:  Lawton, Oklahoma
Salary: Salary to be discussed during phone screen with Bryant Staffing Solutions recruiter
Bonus: Negotiable
Relocation: Partial 
Sponsorship: No visa sponsorships are supported

Job 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

Job Qualifications:

• BSN preferred
• RN compact or Oklahoma state license
• Oklahoma RN Certification in Case Management or Utilization Review is preferred
• Minimum 5 years of experience in case management, discharge planning and/or utilization review in an acute care setting
• Minimum 3 years of Director experience at an acute care facility
• Strong clinical background preferred
• 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

Job tags

Salary