Director of Case Management

San Ramon Regional Medical Center • San Ramon, CA

2d

About The Position

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At San Ramon Regional Medical Center hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success. At San Ramon Regional Medical Center, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. 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 Tenet policy Education provided to physicians, patients, families and caregivers

Requirements

• Bachelor degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW.
• 3 years of acute hospital case management or healthcare leadership experience.
• 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.

Nice To Haves

• MSN, MBA, MSW or MHA.
• 5 years of acute hospital case management leadership multi-site experience
• Accredited Case Manager (ACM)

Responsibilities

• overall responsibility for hospital utilization management
• transition management and operational management of the Case Management Department
• promote effective utilization of hospital resources
• timely and accurate revenue cycle processes
• denial prevention
• safe and timely patient throughput
• compliance with all state and federal regulations related to case management services
• 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

Benefits

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees