Director of Case Management & Utilization

CS&S STAFFING SOLUTIONS; Houston (TX); On-site; USD 120,000 - 180,000; Full time

Job summary

A healthcare staffing agency is seeking a Director of Case Management in Houston, Texas. The role involves managing the Case Management Department, ensuring hospital utilization performance and compliance with regulations. Candidates should possess an active RN license with at least two years of acute hospital case management experience, and prefer an MSN or ACM certification. Strong organizational and communication skills are crucial, along with critical thinking capabilities. This position offers an opportunity to lead a vital department in a fast-paced environment.

Qualifications

• Active Registered Nurse license with at least two years of acute hospital case management experience.
• MSN preferred.
• Accredited Case Manager (ACM) preferred.
• Five years of acute hospital case management experience preferred.

Responsibilities

• Manage department operations for effective throughput and reimbursement.
• Lead implementation of the Utilization Management Plan.
• Ensure medical necessity review processes compliance.
• Ensure timely patient transition and planning.
• Implement processes to prevent payer disputes.
• Provide physician education on hospital utilization.

Skills

Organizational skills

Verbal communication skills

Written communication skills

Critical thinking

Problem solving

Computer literacy

Education

Active Registered Nurse license

MSN preferred

Accredited Case Manager (ACM) preferred

Five years acute hospital case management experience preferred

Tools

McKesson InterQual

Job description

A healthcare staffing agency is seeking a Director of Case Management in Houston, Texas. The role involves managing the Case Management Department, ensuring hospital utilization performance and compliance with regulations. Candidates should possess an active RN license with at least two years of acute hospital case management experience, and prefer an MSN or ACM certification. Strong organizational and communication skills are crucial, along with critical thinking capabilities. This position offers an opportunity to lead a vital department in a fast-paced environment.