Case Management Director FT Days
Company: Saint Francis Hospital - Memphis
Location: Bassett
Posted on: April 17, 2024
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Job Description:
St. Francis Hospital Memphis Saint Francis Hospital Memphis is a
510-bed acute care hospital dedicated to providing high quality,
compassionate care to the Mid-South community. As a comprehensive
medical center, Saint Francis Hospital Memphis features a broad
spectrum of tertiary and acute care, outpatient services and
specialty areas including Women's Services, Surgical Services,
Bariatric Center of Excellence and Behavioral Health. Other acute
care areas include Emergency Room, Critical Care, Med/ Surge and
Telemetry. Case Management Director Full Time Days Blood Bank
Position Summary 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 Responsibilities The individual's
responsibilities include the following activities: a) manage
department operations to assure effective throughput and
reimbursement for services provided, b) lead the implementation and
oversight of the hospital Utilization Management Plan using data to
drive hospital utilization performance improvement, c) ensure
medical necessity and revenue cycle processes are completed
accurately and in compliance with CMS regulations and Tenet policy,
d) ensure timely and effective patient transition and planning to
support efficient patient throughput, e) implement and monitor
processes to prevent payer disputes, f) develop and provide
physician education and feedback on hospital utilization, g)
participate in management of post-acute provider network, h) ensure
compliance with state and federal regulations and TJC accreditation
standards, and i) other duties as assigned. Education Required:
Bachelor degree in Business, Nursing or Health Care Administration
for RN or Master's in Social Work for MSW. Preferred: MSN, MBA, MSW
or MHA. Experience Required: 3 years of acute hospital case
management or healthcare leadership experience. Preferred: 5 years
of acute hospital case management leadership multi-site experience.
Certification 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) 2305046691 Employment
practices will not be influenced or affected by an applicant's or
employee's race, color, religion, sex (including pregnancy),
national origin, age, disability, genetic information, sexual
orientation, gender identity or expression, veteran status or any
other legally protected status. Tenet will make reasonable
accommodations for qualified individuals with disabilities unless
doing so would result in an undue hardship. --s-p-m1-- By applying,
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Keywords: Saint Francis Hospital - Memphis, Memphis , Case Management Director FT Days, Executive , Bassett, Tennessee
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