Company Info
Athens Regional Medical Center

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Athens, GA, United States

Phone: 706-475-7000
Web Site:

Company Profile


Director Case Management


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Category:

Case Management Director-VP

Title:

Director Case Management

Location:

Athens, GA, United States 

Zip Code:

30606
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Employment Type:

Full time

# of Beds:

358
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Job Requirements:

Required Qualifications: ·Minimum of five years of hospital based case management experience required ·Minimum of three of leadership experience required ·Demonstrated collaborative, transformative, and communication skills required ·Experience in ACO or care transitions functions preferred Education: Bachelor's degree in science of nursing a minimum. Master's degree in nursing or other healthcare field preferred Licensure: Currently licensed as a registered nurse in the State of Georgia required Credentials: Essential: * Registered Nurse Education: Essential: * Bachelors of Science - Nursing

Job Description:

Provides overall administration, direction, and development of care coordination 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; and education provided to physicians, patients, families and caregivers. The individual’s responsibilities include: 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 review processes are completed accurately and in compliance with CMS regulations; 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; and ensure compliance with state and federal regulations and TJC accreditation standards.

Job ID:

36207