K.A. Recruiting


RN Director, Case Management

Wellesley, MA 02418

Job Type: Nurse Leadership Opportunities Job Number: CO50

Job Description

Looking for a RN Director of Case Management in Eastern MA!

 

 

Qualifications:

Education:

BS/BSN required, MSN, MBA or MHA preferred. 

Experience:

Required: Two (2) years in Case Management Leadership.
Preferred: Five (5) years acute hospital case management experience preferred. Business planning experience preferred. McKesson InterQual® experience preferred. 

Certifications:
Required: Registered Nurse license. Preferred Accredited Case Manager (ACM).

Skills and Certifications:
Hospital Case Management leadership experience
Registered Nurse 

 

Job Responsibilities:

  • Manage department operations to assure effective throughput and reimbursement for services provided
  • Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement
  • Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy
  • Ensure timely and effective patient transition and planning to support efficient patient throughput
  • Implement and monitor processes to prevent payer disputes
  • Develop and provide physician education and feedback on hospital utilization
  • Participate in management of post-acute provider network
  • Ensure compliance with state and federal regulations and TJC accreditation standards, andi) other duties as assigned.

 

Additional Information

Please click APPLY ONLINE or email us a copy of your resume directly (my email is next to my profile). Be sure to check out all of our jobs at http://jobs.ka-recruiting.com. We look forward to working with you!

Meet Your Recruiter

Chelsey Opalenik
Associate Healthcare Recruiter

Chelsey specializes in placing health care professionals into full time permanent positions nation wide! She is happy to help you navigate the job search and find the best fit for you. When not recruiting Chelsey loves to travel and explore new cities.

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