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RN Director of Case Management - $20k Sign-On Bonus
Tenet Healthcare
Details
Description: The individual in this position has overall responsibility for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure 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 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 review 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) ensure compliance with state and federal regulations and TJC accreditation standards, and h) other duties as assigned.
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Qualifications:
#LI-MH1 |
Internal Number: 1705044449
About Tenet Healthcare
Join Our Team
Quality Care Delivered by Compassionate People.
We know it takes a special person to work in healthcare, and we are committed to providing our people with an enriching and rewarding environment. We deliver the resources, tools and support our employees need to serve our patients and customers in the best way possible — so we can create happier, healthier communities.
Also, we seek and develop emerging executive talent. Our executives lead the strategies and operations that help us deliver quality care across our network. Personal growth is important to us, and while our performance expectations are significant, so is our dedication to each individual's success.
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