Manager - Case Management

Job description

Shift : Days Job Type: Full Time: 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: 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...