Hospital Case Management Director: Patient Flow Lead

Veracity Ventures Inc.; Worcester (MA); Presencial; USD 120 000 - 180 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

401(k)

Dental insurance

Health insurance

Paid time off

Vision insurance

Resumo da oferta

Veracity Ventures Inc. in Worcester, MA seeks a Director of Case Management to lead hospital-wide case management, utilization management, care coordination, and transitions.

You will optimize patient throughput, length of stay, medical necessity, and safe transitions of care while ensuring regulatory compliance. The role focuses on directing daily operations, driving performance improvements with physicians and clinical teams, and advancing readmission prevention and revenue-cycle alignment in

Qualificações

• Bachelor's degree in Nursing, Business, or Healthcare Administration for RN candidates, or Master's degree in Social Work for MSW candidates.
• At least 3 years of acute hospital Case Management or healthcare leadership experience.
• Active RN, LCSW, or LMSW license as applicable.
• Current licensure/registration required to practice in the state of Massachusetts.

Responsabilidades

• Lead the daily operations and performance of the Case Management Department.
• Oversee the hospital Utilization Management Plan and use data to drive performance improvement.
• Ensure accurate medical necessity reviews and utilization processes in accordance with CMS requirements and organizational policies.
• Drive effective patient throughput, discharge planning, and transitions of care.
• Support appropriate length of stay and initiatives focused on readmission prevention.
• Partner with physicians and clinical teams to improve utilization and patient flow.
• Provide education and feedback to physicians regarding hospital utilization and medical necessity.
• Promote compliance with state and federal regulations and accreditation standards.
• Support denial prevention and revenue-cycle processes related to case management.
• Lead initiatives that improve patient experience, care coordination, and operational efficiency.

Conhecimentos

Healthcare leadership

Regulatory compliance

RN/LCSW/LMSW licensing

Data-driven performance

Formação académica

Bachelor's degree in Nursing, Business, or Healthcare Administration

Master's degree in Social Work

Descrição da oferta de emprego

Veracity Ventures Inc. in Worcester, MA seeks a Director of Case Management to lead hospital-wide case management, utilization management, care coordination, and transitions.

You will optimize patient throughput, length of stay, medical necessity, and safe transitions of care while ensuring regulatory compliance. The role focuses on directing daily operations, driving performance improvements with physicians and clinical teams, and advancing readmission prevention and revenue-cycle alignment in