Prime Healthcare

Director of Case Management

Facility Southern Regional Medical Center
Location
US-GA-Riverdale
ID
2024-158417
Category
Director
Position Type
Full Time
Shift
Variable
Job Type
Exempt

Overview

          Southern Regional MC

 

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Southern Regional Medical Center, a member of the Prime Healthcare Foundation, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

 

Southern Regional Medical Center is a non-profit, 331-bed full-service hospital serving the residents of Clayton County and southern crescent metro Atlanta communities. The hospital offers a complete line of services including Senior Care and Senior Behavioral Health Services, Emergency Services, Heart and Vascular, Advanced Imaging, Laboratory, Neuroscience Services, Rehabilitation, Sleep Diagnostic Center, Surgery/Robotic Surgery, Wound Care and Women’s Health Services, including a Level III NICU. The hospital is certified accredited as a Chest Pain Center and Primary Stroke Center.

 

Benefits Statement

We offer:

  • Competitive Compensation
  • Generous benefits plan: Medical, Dental, Vision, 401K
  • Substantial PTO
  • Continuing Educational Opportunities
  • Collaborative work teams & cohorts
  • …and much more!

Are you ready to make a difference?  Be part of our Team, let us be part of your future!

 

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Responsibilities

 We are looking for a Director of Case Management.  In this position you will be responsible for the following:

 

  • Leading and meeting the length of stay intitiatives and metrics.
  • Frequent communication with hospitalists, intensivists, and community physicians regarding length of stay and discharge planning.
  • Communication with nursing managers, etc length of stay, discharge planning and patient status.
  • Manage bundled payment improvements.
  • Perform concurrent daily review and audit of case management and discharge planning documentation.
  • Assist in appeal process on any insurance denial when requested.
  • Participate in education for Case Managers, Social Workers, nursing and medical staff regarding care coordination.

 

As you would expect, the Director of Case Management would oversee a team of case managers, track department progress, review treatment plans and goals and provide feedback for case managers The Director of Case Management will also assist with discharge planning and appealing insurance denials.

 

 

Qualifications

Education and Work Experience

  1. Minimum 5 years post graduate of an accredited school of nursing and a currently state Registered Nurse license.
  2. Required to have a minimum of 5 years experience in a Case Management position.
  3. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
  4. Certification in Case Management, BS or BSN or related field preferred.
  5. Current BCLS (AHA) certificate upon hire and maintain current.
  6. Knowledge of Milliman Criteria and InterQual Criteria preferred.
  7. Experience and knowledge in basic to intermediate computer skills.
  8. Current Behavioral Violence Prevention Training within 3 months of hire and maintain current.

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

 

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