Nurse Director Case Management in California

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 hospital 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.

Requirements

Bachelor’s degree in business, Nursing or Health Care for RN or master’s in social work for MSW.   

Preferred: MSN, MBA, MSW or...