Case Management Director oversees a staff of case managers responsible for patient care coordination. Develops and implements case management programs, including utilization review, intake or discharge planning, and managed care contracting or negotiation. Being a Case Management Director evaluates patient care data to ensure that care is provided in accordance with clinical guidelines and organizational standards. Seeks treatments that balance clinical and financial concerns with the family's needs and the patient's quality of life. Additionally, Case Management Director contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care. Typically requires a bachelor's degree. Typically reports to top management. May require Registered Nurse (RN). The Case Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Case Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)
JOB SUMMARY:
Under the supervision of the Lead Case Manager, or Director of Quality, this role completes various duties to enhance the efficiency of the Case Management Department, as well as support the daily functions of the case managers. This role assists in securing arrangements for the discharge transition and post-acute services. While monitoring the revenue cycle process related to insurance certifications, insurance verification, peer-to-peer completion, and denial/appeal tracking, this position serves as a liaison between the Case Management Department, payers, and additional entities.
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0 Case Management Director jobs found in Tulsa, OK area