Director of Case Management

Tenet Healthcare Corporation • Modesto, CA

2d • $72 - $115 • Onsite

About The Position

This position reports directly to the Regional Case Managment Director, Indirectly Reports to the Chief Financial Officer. The individual in this position has overall responsibility for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure 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. Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Doctors Medical Center of Modesto hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.

Requirements

• Minimum two years acute hospital case management leadership experience required.
• 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.
• Computer literacy.
• Must complete Tenet’s InterQual education course within 30 days of hire (and at least annually thereafter) and pass with a score of 85 or better.
• Must complete and demonstrate competency in using the Tenet Case Management documentation system within 30 days of hire.
• Attendance at hospital orientation is required.
• Must work with regional Performance Management and Innovation (PMI) Case Management leader to complete PMI Director of Case Management orientation within 90 days of hire.
• Current and valid: Registered Nurse license, CA driver's license and proof of automotive insurance.

Nice To Haves

• MSN preferred.
• Accredited Case Manager (ACM) preferred.
• McKesson InterQual® experience preferred.
• Five years acute hospital case management experience preferred.
• Business planning experience preferred.

Responsibilities

• Overall responsibility for hospital utilization performance improvement and operational management of the Case Management Department.
• Promote effective utilization of hospital resources.
• Ensure processes support appropriate reimbursement for services rendered.
• Support efficient patient throughput.
• Ensure compliance with all state and federal regulations related to case management services.
• Integrate 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.

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