Director of Case Management

Location

Lawton, OK | United States

Job description

Job summary:

• Oversight of the Facilitys 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

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

Job tags

Salary