Case Management Director FT Days

Company: Saint Francis Hospital - Memphis
Location: Bassett
Posted on: April 17, 2024

Job Description:

St. Francis Hospital Memphis


Saint Francis Hospital Memphis is a 510-bed acute care hospital dedicated to providing high quality, compassionate care to the Mid-South community. As a comprehensive medical center, Saint Francis Hospital Memphis features a broad spectrum of tertiary and acute care, outpatient services and specialty areas including Women's Services, Surgical Services, Bariatric Center of Excellence and Behavioral Health. Other acute care areas include Emergency Room, Critical Care, Med/ Surge and Telemetry.


Case Management Director Full Time Days Blood Bank Position Summary


The individual in this position 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 Tenet policy
--- Education provided to physicians, patients, families and caregivers



Responsibilities


The individual's responsibilities include the following activities: a) manage department operations to assure effective throughput and reimbursement for services provided, b) lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement, c) ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy, d) ensure timely and effective patient transition and planning to support efficient patient throughput, e) implement and monitor processes to prevent payer disputes, f) develop and provide physician education and feedback on hospital utilization, g) participate in management of post-acute provider network, h) ensure compliance with state and federal regulations and TJC accreditation standards, and i) other duties as assigned.


Education


Required: Bachelor degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW.
Preferred: MSN, MBA, MSW or MHA.



Experience


Required: 3 years of acute hospital case management or healthcare leadership experience.
Preferred: 5 years of acute hospital case management leadership multi-site experience.


Certification


Required: Registered Nurse or LCSW/LMSW license. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN or LCSW/LMSW license for state(s) covered.
Preferred: Accredited Case Manager (ACM)


2305046691
Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

--s-p-m1--

By applying, you consent to your information being processed by SonicJobs and transmitted to the Employer.
See SonicJobs Terms & Conditions at https://www.sonicjobs.com/us/terms-conditions and Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

Keywords: Saint Francis Hospital - Memphis, Southaven , Case Management Director FT Days, Executive , Bassett, Mississippi