Manager - Case Management
About The Position
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 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.
Responsibilities
- manage department operations to assure effective throughput and reimbursement for services provided
- lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement
- ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy
- ensure timely and effective patient transition and planning to support efficient patient throughput
- implement and monitor processes to prevent payer disputes
- develop and provide physician education and feedback on hospital utilization
- participate in management of post acute provider network
- ensure compliance with state and federal regulations and TJC accreditation standards
- other duties as assigned
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
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
