Director, Case Management & Utilization

Direct Staffing Inc; Lakewood (CO); On-site; USD 85,000 - 120,000; Full time

Job summary

A healthcare staffing agency is seeking a Case Management Director in Lakewood, Colorado, responsible for leading hospital utilization performance improvement and operational management of the Case Management Department. The role requires a current RN license and at least five years of acute care experience with two years in a leadership position. Responsibilities include managing department operations, ensuring compliance with regulations, and developing education for staff. This position is vital for promoting effective hospital resource utilization and ensuring patient care quality.

Qualifications

• Current CA RN license is required.
• Must have 5 years of acute care experience.
• Two years of leadership in acute hospital case management is needed.
• Demonstrated organizational skills are essential.
• Excellent verbal and written communication skills required.
• Ability to lead diverse groups in a fast-paced environment needed.
• Critical thinking and problem-solving skills necessary.

Responsibilities

• Manage department operations to assure effective throughput and reimbursement.
• Lead hospital Utilization Management Plan implementation.
• Ensure accurate medical necessity review processes.
• Support timely patient transition and planning.
• Monitor processes to prevent payer disputes.
• Develop and provide education on hospital utilization.
• Ensure compliance with regulations and standards.

Skills

Organizational skills

Excellent verbal and written communication

Critical thinking

Problem solving

Education

Current CA RN license

5 years acute care experience

Two years acute hospital case management leadership

Job description

A healthcare staffing agency is seeking a Case Management Director in Lakewood, Colorado, responsible for leading hospital utilization performance improvement and operational management of the Case Management Department. The role requires a current RN license and at least five years of acute care experience with two years in a leadership position. Responsibilities include managing department operations, ensuring compliance with regulations, and developing education for staff. This position is vital for promoting effective hospital resource utilization and ensuring patient care quality.