Director, Case Management & Utilization Excellence

Central Business Solutions, Inc; Memphis (TN); On-site; USD 120,000 - 160,000; Full time

Job summary

Central Business Solutions, Inc. seeks a Director of Case Management to oversee hospital utilization, transition management, and department operations.

You will drive throughput, ensure compliant revenue cycle processes, and provide education to physicians and staff across the care continuum. The role requires a Bachelor's in Business, Nursing, or Health Care Administration (RN preferred) and 3 years of acute hospital case management or healthcare leadership experience.

Qualifications

• Required: Bachelor's degree in Business, Nursing or Health Care Administration; RN preferred.
• Required: Master's in Social Work for MSW.
• Experience: 3 years in acute hospital case management or healthcare leadership.
• Licensure/Certification: Active RN or LCSW/LMSW licensed.
• Must be licensed to practice in state(s) covered.
• Preferred: 5 years of acute hospital case management leadership, multi-site experience.
• Education: MSN, MBA, MSW, or MHA.

Responsibilities

• Manage department operations to assure effective throughput and reimbursement.
• Lead the implementation and oversight of the Utilization Management Plan using data to drive performance.
• Ensure medical necessity and revenue cycle processes comply with CMS regulations and policy.
• Ensure timely patient transition and planning to support efficient throughput.
• Develop and provide physician education on hospital utilization.

Skills

Leadership

Healthcare administration

Data-driven decisions

Education

Bachelor's degree in Business, Nursing or Health Care Administration

Master's in Social Work (MSW)

Job description

Central Business Solutions, Inc. seeks a Director of Case Management to oversee hospital utilization, transition management, and department operations.

You will drive throughput, ensure compliant revenue cycle processes, and provide education to physicians and staff across the care continuum. The role requires a Bachelor's in Business, Nursing, or Health Care Administration (RN preferred) and 3 years of acute hospital case management or healthcare leadership experience.