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RN/Director of Case Management (840806) $10,000 sign on bonus

Company: Veritas Global Consulting Group, LLC
Location: San Luis Obispo
Posted on: March 14, 2020

Job Description:

JOB CODE: (840806) RN/Director of Case Management LOCATION: Central Coast (CA) Enjoy up to a $10,000 sign on bonus with this great opportunity to join a health care system renowned as an innovative leader with a network spanning over 70 acute care hospitals and more than 170 outpatient centers nationwide with more than 100,000 professionals committed to providing high quality care to patients in the communities they serve. Be a part of a team delivering the perfect combination of excellent patient care with compassion and at the same time, enjoy working for an organization that offers a culture of respect and collaboration attracting some of the best physicians, skilled nurses, and compassionate caregivers, along with extensive resources, comprehensive educational programs, real advancement potential, and a spirit of inclusion and teamwork! The Director of Case Management has overall responsibility for hospital utilization management, transition management and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care Compliance with state and federal regulatory requirements, TJC accreditation standards and Company policy Education provided to physicians, patients, families and caregivers 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 Company 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, and) other duties as assigned QUALIFICATIONS: BS/BSN preferred (BSN required if Magnet Hospital). MSN, MBA or MHA preferred. Two (2) years in Case Management leadership required Five (5) years acute hospital case management experience preferred Business planning experience preferred McKesson InterQual experience preferred Registered Nurse license required Accredited Case Manager (ACM) certification preferred The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the position. For consideration, please send us your CV/resume in MS Word format only. If there is a viable match, one of our consultants will contact you within 24-48 hours. To ensure that our response to your application reaches your INBOX (not your junk or spam folder), please add our email address,, to your Safe Senders list or to your Address Book.

Keywords: Veritas Global Consulting Group, LLC, San Luis Obispo , RN/Director of Case Management (840806) $10,000 sign on bonus, Executive , San Luis Obispo, California

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