Director of Case Management
East Texas

The Director of Case Management coordinates utilization management activities dealing daily with insurance carriers on denials and appeals. The Director of Case Management directs and oversees Utilization Management/Care Coordination/Social Service/Discharge Planning activities. The Director of Case Management provides in-service training and continuing education to staff and is available as a resource in day to day management of both departments. The Director of Case Management coordinates weekly report on major cases. The Director of Case Management ensures compliance with CMS as well as JCAHO in regard to utilization management and social service activities.

Qualifications:

BSN required, with MSN or Master's level Business degree preferred
Registered Nurse
Leadership Case management/social work team involving collaborative team work with other disciplines preferred
Acute Care Case Management experience with inpatient hospital and insurance based case management
CCM required
Self-starter, responsible, accountable, goal driven individual
Medicare/Medicaid/managed care reimbursement rules and regulations experience
InterQual background or similar criteria based medical necessity guidelines experience
Impact in Medicare Performance Improvement
Ability to lead by example

If this opportunity is of interest, please feel free to contact me at your earliest convenience. If there is someone that you know who may be interested in this opportunity, I would appreciate the referral. Thanks!

For all of our Case Management opportunities, visit our Case Management website at www.casemanagementrecruiter.com.

Michelle Boeckmann, VP of Recruitment
MBoeckmann@theclinicalrecruiter.com
Direct Dial 615-224-8405 | Toll Free 800-568-0828 ext. 109
Fax: 888-226-0953