staff - Director Registered Nurse (RN) - Case Management - $72-115 per hour

Tenet North Cal; Modesto (CA); On-site; USD 120,000 - 170,000; Full time

Job summary

Tenet North Cal seeks an RN Case Management Director to lead the Case Management Department in Modesto, CA. The role focuses on utilization management, patient throughput, and compliance with regulatory standards.

The director will oversee coordination of care, transitions, and provider education while ensuring appropriate resource utilization and reimbursement. MSN and ACM are preferred, with extensive leadership and hospital-based case management experience required.

Qualifications

• MSN preferred; ACM preferred.
• Two years acute hospital case management leadership experience required.
• Five years acute hospital case management experience preferred.
• Demonstrated organizational, verbal and written communication skills; ability to lead diverse teams.
• Business planning experience preferred.
• Must complete Tenet’s InterQual education course within 30 days of hire (and annually thereafter) with score 85+.
• Must complete and demonstrate competency in using Tenet Case Management documentation system within 30 days of hire.
• Attendance at hospital orientation is required.
• Must work with PMI Case Management leader to complete PMI Director orientation within 90 days of hire.

Responsibilities

• Oversee hospital utilization performance improvement and operational management of the Case Management Department.
• Promote efficient patient throughput and appropriate reimbursement for services.
• Ensure compliance with state and federal regulations related to case management.
• Lead utilization management, transition management, and care coordination to optimize care delivery.
• Provide education to physicians, patients, families and caregivers per Tenet policy.

Skills

Leadership

Communication

Critical thinking

Organizational skills

Problem solving

Computer literacy

Education

MSN

ACM

Tools

McKesson InterQual

Tenet Case Management system

Job description

Tenet North Cal is seeking a Registered Nurse (RN) Case Management Director for a nursing job in Modesto, California.

Job Description & Requirements

Job Details

• Specialty: Case Management
• Discipline: RN
• Duration: Ongoing
• Employment Type: Staff
• Job Type: Full Time
• Job Shift: Days
• Holiday Rotation:
• Department: Case Management
• This position reports directly to the Regional Case Management Director, Indirectly Reports to the Chief Financial Officer.
• The individual in this position has overall responsibility for hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.

Responsibilities

This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction, care coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care, compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy education provided to physicians, patients, families and caregivers.

Position Qualifications

• Minimum Education: MSN preferred. Accredited Case Manager (ACM) preferred.
• Minimum Experience/Skills: Minimum two years acute hospital case management leadership experience required. McKesson InterQual® experience preferred. Five years acute hospital case management experience preferred.
• Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computer literacy.
• Business planning experience preferred.
• Must complete Tenet’s InterQual education course within 30 days of hire (and at least annually thereafter) and pass with a score of 85 or better.
• Must complete and demonstrate competency in using the Tenet Case Management documentation system within 30 days of hire.
• Attendance at hospital orientation is required.
• Must work with regional Performance Management and Innovation (PMI) Case Management leader to complete PMI Director of Case Management orientation within 90 days of hire.

License/Certificates/Credentials

Current and valid: Registered Nurse license, CA driver's license and proof of automotive insurance.

Physical Demands

While performing the duties of this job, the employee is regularly required to sit, talk, and hear. The employee is frequently required to use fine motor skill (typing/data entry), and reach with hands and arms. The employee is frequently required to stand; walk; and occasionally stoop, kneel, or crawl. Lift/position up to 25 lbs. Push/pull up to 25 lbs of force.

Vision Requirements

Sufficient perceptive acuity (vision and hearing) to perform all the related duties of the position. Ability to adjust vision sufficiently to perform duties.

Working Conditions

Individual works in a fast paced clinical and office environment.

#LI-JG2

Tenet North Cal Job ID #2603024788. Posted job title: Director of Case Management