RN Case Management Director – Lead Utilization & Transitions

Tenet Massachusetts; Worcester (MA); On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

Sign-On Bonus

Job summary

Tenet Massachusetts is seeking an RN Case Management Director in Worcester, Massachusetts. The role oversees hospital utilization, transition management and department operations to promote efficient resource use and compliant processes.

Requirements include a Bachelor’s in Business, Nursing or Health Care Administration (RN) with 3 years’ leadership in acute care; an RN or LCSW/LMSW license is required. A Master’s in Social Work or related credential is preferred, with a $20,000 sign-on bonus

Qualifications

• Education: Bachelor's degree... RN or MSW path as stated.
• Experience: 3 years in acute hospital case management or healthcare leadership.
• Licensure/Certification: Active RN or LCSW/LMSW license; must be licensed.
• Strong knowledge of case management standards and CMS regulations.

Responsibilities

• Manage department operations to assure effective throughput and reimbursement for services provided.
• Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive performance improvement.
• Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy.
• Ensure timely patient transition and planning to support efficient throughput.
• Develop and provide physician education and feedback on hospital utilization.

Skills

RN leadership

Healthcare administration

Utilization management

Throughput improvement

Education

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

Master's in Social Work (MSW)

Job description

Tenet Massachusetts is seeking an RN Case Management Director in Worcester, Massachusetts. The role oversees hospital utilization, transition management and department operations to promote efficient resource use and compliant processes.

Requirements include a Bachelor’s in Business, Nursing or Health Care Administration (RN) with 3 years’ leadership in acute care; an RN or LCSW/LMSW license is required. A Master’s in Social Work or related credential is preferred, with a $20,000 sign-on bonus