Director Case Management
hace 1 mes
Director Case Management
San Ramon, CA
185K-240K + Signing Bonus + Performance Bonus + Paid Relocation
Job 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, prescription drug, dental, vision, behavioral health and telemedicine services.
Wellbeing support, including employee assistance program (EAP).
Time away from work programs for paid time off, long- and short-term plan coverage.
Savings and retirement including a 401(k) Plan with a 50% match up to 6% of pay, employee stock purchase plan, flexible spending accounts, retirement readiness tools, rollover support, and financial well-being counseling.
Education support through tuition assistance, student loan assistance, certification support, and online educational program.
Additional benefits life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and employee discount program.
Registered nurses – Retirement medical benefit account (RMBA) – 2% of annual eligible income set aside in accordance with program guidelines.
Benefits may vary by location and role.
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 hospital 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 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: 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.
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.
#J-18808-Ljbffr
-
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...
-
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...
-
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,...
-
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...
-
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...
-
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,...
-
Frailes, Puerto Rico Resiliency 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...
-
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...
-
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...
-
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...
-
Director Clinical Quality Improvement
hace 1 mes
Frailes, Puerto Rico Jamie Grayem A tiempo completoDIRECTOR CLINICAL QUALITY IMPROVEMENTSan Ramon, CA160-225K + Bonus + Signing Bonus + Paid Relocation 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...
-
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...
-
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...
-
Physician Clinic Medical Director
hace 3 meses
Frailes, Puerto Rico Concentra A tiempo completoOverview: Clinic Medical Director Are you looking for a physician practice with a family environment, but with the benefits and support a large organization can provide? Where daily patient care is backed by evidenced based medicine and career options are limitless, then look no further! Position Summary At Concentra, our Medical Directors spend the majority...
-
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...
-
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...
-
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...
-
Senior Living Sales And Marketing Director
hace 2 meses
Frailes, Puerto Rico Jobleads-Us A tiempo completoCurrent job opportunities are posted here as they become available.Subscribe to our RSS feeds to receive instant updates as new positions become available.Senior Living Sales and Marketing DirectorIvy Park at San Ramon is a premier senior living community situated on a beautifully landscaped campus. Managed by Oakmont Management Group, we provide exceptional...
-
Frailes, Puerto Rico Jobleads-Us A tiempo completoDirector and Chief of Staff, Indigenous PortfolioJob no: 0033809Location: ParkvilleRole type: Full-time, ContinuingDepartment: Office of the Provost - Indigenous StrategySalary: Senior Manager 2 - An attractive remuneration package to be negotiated; plus 17% super paA senior role in a collaborative, culturally rich environment, leading the largest Indigenous...
-
Supervisor, Gas Quality Management
hace 1 mes
Frailes, Puerto Rico Pg&E A tiempo completoRequisition ID# 160726 Job Category: Compliance / Risk / Quality Assurance Job Level: Supervisor Business Unit: Gas Operations Work Type: Hybrid Job Location: San Ramon; Alameda; Alta; American Canyon; Angels Camp; Antioch; Auberry; Auburn; Avenal; Avila Beach; Bakersfield; Balch Camp; Bear Valley; Belden; Bellota; Belmont; Benicia; Berkeley; Brentwood;...
