Director of Case Management
Prime Healthcare•Olympia Fields, IL
•Onsite
About The Position
The Director of Case Management leads Case Management, Utilization Review, Social Work, Care Coordination, and Discharge Planning, driving effective resource utilization, patient throughput, quality outcomes, and regulatory compliance.
Requirements
- Licensed clinician in your state.
- Grandfathered prior to April 1, 2015.
- Minimum 5 years’ post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
- Minimum 5 years’ experience in a Case Management position.
- Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
- Experience and knowledge in basic to intermediate computer skills.
Nice To Haves
- Certification in Case Management, BS or BSN or related field preferred.
- Current BCLS certificate preferred.
- Knowledge of Milliman Criteria and InterQual Criteria preferred.
Responsibilities
- Lead Case Management, Social Work, Utilization Review, and Discharge Planning teams.
- Drive patient throughput, LOS, utilization management, readmission, and denial prevention strategies.
- Partner with physicians, nursing, payers, and interdisciplinary teams to remove barriers to care and discharge.
- Monitor performance metrics and lead quality and process improvement initiatives.
- Ensure compliance with CMS, accreditation, regulatory, and payer requirements.
Benefits
- paid time off
- a 401K retirement plan
- medical, dental, and vision coverage
- tuition reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Director
