Director Of Case Management(Rn) With Acute Care Facility Mgmt Exp
hace 3 meses
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 satisfactionCare 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 hospital policy Education provided to physicians, patients, families and caregiversThe individual's responsibilities include the following activities: 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 hospital 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, other duties as assigned. QUALIFICATIONS:EducationRequired: 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.ExperienceRequired: 3 years of acute hospital case management or healthcare leadership experience. Preferred: 5 years of acute hospital case management leadership multi-site experienceCertificationRequired: 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)Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computer literacy. Business planning experience preferred.
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Director Case Management
hace 1 mes
Frailes, Puerto Rico Jobleads-Us A tiempo completoDirector Case ManagementSan Ramon, CA185K-240K + Signing Bonus + Performance Bonus + Paid RelocationJob DescriptionSUMMARY: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...
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Director Of Case Management
hace 1 mes
Frailes, Puerto Rico Viper Staffing Services L.L.C. A tiempo completo(Hiring) Director of Case Management We are seeking an Director of Case Management to join our team! Responsibilities: The Director of Case Management plays a pivotal role in ensuring the delivery of high-quality, patient-centered care while optimizing resource utilization and operational efficiency within the hospital setting. This position requires...
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Director Case Management
hace 1 mes
Frailes, Puerto Rico Jobleads-Us A tiempo completoDirector Case ManagementSan Ramon, CA185K-240K + Signing Bonus + Performance Bonus + Paid RelocationJob Description We offer competitive salaries and benefits including a matching 401(k), several health & dental plans to choose from, generous tuition assistance plans, and relocation assistance for select positions.Comprehensive benefits for medical,...
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Director Case Management
hace 1 mes
Frailes, Puerto Rico Jobleads-Us A tiempo completoDirector Case ManagementSan Ramon, CA185K-240K + Signing Bonus + Performance Bonus + Paid RelocationJob Description We offer competitive salaries and benefits including a matching 401(k), several health & dental plans to choose from, generous tuition assistance plans, and relocation assistance for select positions.Comprehensive benefits for medical,...
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Director Of Case Management
hace 2 meses
Frailes, Puerto Rico Health Talent Pro A tiempo completoSUMMARY: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...
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Director of Case Management Operations
hace 3 semanas
Frailes Barrio, Puerto Rico Knowhirematch A tiempo completoJob Summary:The Director of Case Management Operations will lead the Case Management Department in promoting 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...
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Director of Clinical Operations
hace 4 semanas
Frailes Barrio, Puerto Rico Edge Recruitment Solutions Llc A tiempo completoDirector of Case ManagementWe are seeking a highly skilled and experienced Registered Nurse or LCSW/LMSW to lead our Case Management Department as Director. The ideal candidate will have a strong background in acute hospital case management and a proven track record of promoting effective utilization of hospital resources, timely and accurate revenue cycle...
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Clinical Operations Manager
hace 3 semanas
Frailes Barrio, Puerto Rico Resiliency A tiempo completoRole SummaryThe Clinical Operations Manager - Case Management will oversee hospital utilization management, transition management, and operational management of the Case Management Department. This role aims to promote effective hospital resource utilization, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput,...
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Nursing Director Rn
hace 1 mes
Frailes, Puerto Rico Incredible Health A tiempo completoIncredible Health is actively hiring for a Registered Nurse - Case Management Director position in the San Ramon, CA area. We are seeking experienced nurses with a background in case management, assistant nurse management, or clinical nurse coordination. The ideal candidate will have a strong understanding of clinical pathways, utilization review, and...
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Interim Director Quality Management
hace 1 mes
Frailes, Puerto Rico Amn Healthcare A tiempo completoJob Details Interim Director of Quality Management Needed in California Healthcare Facility The Position An Interim Director of Quality Management is needed to support and lead quality improvement initiatives for a healthcare facility in California. This role will report directly to the Chief Clinical Officer (CCO) and collaborate closely with department...
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Nursing Director Rn
hace 4 semanas
Frailes Barrio, Puerto Rico Incredible Health A tiempo completoIncredible Health is seeking a seasoned Registered Nurse to lead our case management teams in the San Ramon, CA area. The ideal candidate will have a strong background in case management, assistant nurse management, or clinical nurse coordination, with a proven track record of improving patient outcomes through effective clinical pathways and leadership...
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Rn Clinical Care Coordinator
hace 4 semanas
Frailes, Puerto Rico Grand Oaks Nursing & Rehabilitation Center A tiempo completoGrand Oaks Nursing & Rehabilitation Center is seeking the top candidate and accepting applications for a highly motivated *Clinical Care Coordinator. *Choose a challenging and rewarding career with Peplinski Group's Nursing & Rehabilitation Centers, where you can enjoy a deep sense of personal satisfaction by making a positive and meaningful difference in...
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Clinical Nurse Specialist, Rn Nicu Ft Days
hace 3 meses
Frailes, Puerto Rico Kaiser Permanente A tiempo completoThe Clinical Nurse Specialist role at Kaiser Permanente Southern California Region is a clinical manager who partners with the operational manager to ensure that nursing staff delivers safe and effective care. The role is built around the five role subcomponents as regulated by the California Board of Registered Nursing: Leadership, Consultation, Research,...
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Director Clinical Quality Improvement
hace 3 meses
Frailes, Puerto Rico Veracity A tiempo completoDirector Clinical Quality Improvement San Ramon, California The individual in this position is a key member of the hospital management team, and provides leadership and oversight to the strategic development and implementation of the quality and patient safety programs (performance improvement, patient safety, and accreditation) with responsibility for...
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Director Of Finance
hace 1 mes
Frailes, Puerto Rico Jobleads-Us A tiempo completoAbout Beewise: Beewise is a climate tech company on a mission to secure the global food supply by saving bees, a species responsible for pollinating 75% of the crops we eat. We provide a sustainable AI-powered robotic solution for beekeepers looking to protect their colonies from collapse, and to growers looking to improve their crop yields with superior...
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Home Health Care Nurse
hace 2 semanas
Frailes Barrio, Puerto Rico Bayada Home Health Care A tiempo completoHome Health Care OpportunityBAYADA Home Health Care is seeking an experienced Licensed Practical Nurse (LPN) for a full-time position in Baltimore County, Maryland. As a home care nurse, you will be part of a multi-disciplinary health care team providing skilled nursing and rehabilitative care to clients in their homes. This role offers flexibility and a...
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Registered Nurse
hace 4 semanas
Frailes, Puerto Rico Grand Oaks Nursing & Rehabilitation Center A tiempo completoWe are seeking *FULL TIME & PART TIME * *Registered Nurses* on *3rd shift *to provide and coordinate nursing care in compliance with facility and regulatory policies and procedures and to assess residents' care needs and take appropriate action to ensure they are cared for physically, emotionally & socially.Positions are LIMITED! Apply Now!*Salary...
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Frailes, Puerto Rico Family Health Care A tiempo completoWhy Family Health Care? Progressive, non-profit, outpatient group practice Active provider retention and burnout reduction plan of action One-Stop-Shopping concept for all health care services: medical, dental, behavioral health, pharmacy, laboratory, radiology, and vision Accredited by the Accreditation Association for Ambulatory Health Care (AAAHC)...
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Director Of Finance
hace 1 mes
Frailes, Puerto Rico Jobleads-Us A tiempo completoSamson Rose has been engaged by a client in the robotics, climate tech, and food supply space to help find them a Director of Finance. This person will play a pivotal role in shaping the financial strategy of their US operations and is their first US based senior finance hire.This leadership position requires a strategic thinker with a strong background in...
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Director Surgical Services Full Time Days
hace 3 meses
Frailes, Puerto Rico The National Coalition Of Healthcare Recruiters A tiempo completo23.1 miles from Fremont (Only QUALIFIED Healthcare Professionals accepted)Director of Surgical Services - Director Surgical Services Full Time DaysSan Ramon, CaliforniaJO# 34421* Relocation Assistance *Summary: Active and current registered nurse license in the state of residence/practice. Has highly effective interpersonal and communication skills, proven...
