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Vacancy Expired

Director of Case Management - FT Days

Director of Case Management – FT Days

Position Overview:

  • The Director of Case Management plans, organizes, implements, and directs care coordination activities at Piedmont Medical Center. 
  • He/she is responsible for providing oversight and broad direction to case management, which includes care coordination, utilization review, social services, and discharge planning.
  • The Director of Case Management works closely with the medical staff and Piedmont Medical Center leadership to identify patient care trends and issues. 
  • The Director develops care management programs, procedures, and clinical pathways that ensure efficient use of medical resources and provide optimum cost effective, quality care.

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 the hospital's 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 and other duties as assigned.

Desired Experience, Education, Licenses, and Certifications:

  • Minimum Education:    BSN or LMSW required, MSN preferred, willing to pursue Masters.
  • Minimum Experience: Five to seven years of experience with utilization review, clinical pathways, case management, and disease management are required.  Supervisory experience is preferred.
  • Required: 3 years of acute hospital case management or healthcare leadership experience
  • Preferred: 5 years of acute hospital case management leadership multi-site experience
  •  
  • This position requires proficiency in working with medical statistics and data, including databases. 
  • Experience with medical statistical process and control procedures is required.
  • Required: 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.
  • Preferred: Accredited Case Manager (ACM)
  • The Director of Case Management must possess excellent written and verbal communication skills and demonstrate the ability to prepare statistical data and report for formal presentations. 
  • The Director of Case Management must effectively interact with individuals who possess diverse personalities and levels of professional expertise.

Physical Demands:

  • Lift/position up to 25 lbs.
  • Push/pull up to 25 lbs. of force.
  • Frequent sitting.
  • Moderate standing, walking, reaching, stooping, and bending.
  • Manual dexterity, mobility, touch, auditory to perform all the related duties of the position.


Location: Rock Hill | Salary: | Job type: Permanent | Posted: 01/01/0001

Vacancy Expired