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.
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Keywords: Saint Francis Hospital - Memphis, Bartlett , Case Management Director FT Days, Executive , Bassett, Tennessee
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