Director of Case Management & Care Coordination

ICP Solutions Limited; Cranston (RI); In loco; USD 120.000 - 180.000; Tempo pieno

Descrizione del lavoro

The Rhode Island BHDDH is seeking an experienced Director of Case Management to lead the Case Management Program at Eleanor Slater Hospital and oversee hospital-wide case management, utilization management, discharge planning, and care coordination.

This role requires RN licensure in Rhode Island and a proven track record in leadership, program oversight, and regulatory compliance within acute care settings. Strong collaboration with payers, providers, and interdisciplinary teams is essential.

Competenze

• BSN from an accredited program
• Current unrestricted RN license in Rhode Island
• 5+ years clinical case management in acute care
• Experience with insurance authorization processes (pre-auths, denials, appeals)
• Leadership of multidisciplinary teams
• Strong knowledge of reimbursement and discharge planning

Mansioni

• Provide leadership for hospital case management and utilization management
• Develop and monitor policies, procedures, and performance metrics for compliance
• Oversee quality improvement and performance initiatives
• Participate in interdisciplinary rounds and coordinate individualized care plans
• Oversee discharge planning and care coordination with post-acute providers
• Direct insurance authorizations and payer relations, including denials and appeals
• Ensure compliance with regulatory requirements and confidentiality standards

Descrizione del lavoro

The Rhode Island BHDDH is seeking an experienced Director of Case Management to lead the Case Management Program at Eleanor Slater Hospital and oversee hospital-wide case management, utilization management, discharge planning, and care coordination.

This role requires RN licensure in Rhode Island and a proven track record in leadership, program oversight, and regulatory compliance within acute care settings. Strong collaboration with payers, providers, and interdisciplinary teams is essential.