Director of Case Management
Detroit, MI
About Us: Join a leading healthcare organization in Detroit, Michigan, where we are dedicated to providing exceptional patient care and fostering a supportive and positive work environment. As part of our team, you will play a pivotal role in shaping the future of healthcare in our community. Detroit is a city rich in culture, surrounded by the stunning Great Lakes, and offers a wide range of recreational activities and educational opportunities.
Job Overview: We are seeking an experienced and dynamic Director of Case Management to lead our department. This role is instrumental in ensuring the delivery of high-quality, cost-effective care by managing department operations, utilization, transition management, care coordination, and education. The ideal candidate will possess a strong background in acute hospital case management leadership and a commitment to excellence.
Competitive Compensation: $106,000 - $135,000 based on experience. Comprehensive benefits package and possible relocation assistance available.
Key Responsibilities:
Department Operations:
Maintain an optimal staff mix to meet department goals.
Implement staffing requests in line with recommendations and budget.
Conduct departmental meetings and continual education for staff.
Review competencies and develop action plans for improvement.
Utilization Management:
Oversee medical necessity reviews to ensure proper patient care levels.
Manage the submission of cases to Physician Advisor and utilization review processes.
Advocate with payers for appropriate payment for services.
Transition Management:
Guarantee the completion of transition plan assessments within 24 hours of admission.
Ensure effective patient placement through electronic referral processes.
Care Coordination:
Collaborate with healthcare teams to ensure timely patient care.
Monitor the sequencing of consults, testing, and procedures for efficient delivery.
Education & Compliance:
Provide education on medical necessity, documentation, and compliance.
Ensure the department adheres to federal, state, and local regulations.
Minimum Qualifications:
Bachelor’s degree in Nursing or related health field; Master’s preferred.
Current Michigan RN license.
3-5 years of acute hospital case management leadership experience.
McKesson InterQual® experience preferred.
Accredited Case Manager (ACM) certification is a plus.
Skills Required:
Analytical and fiscal management abilities.
Strong communication, teaching, and project management skills.
Leadership skills with demonstrated experience.
Seniority Level: Director
Minimum Education: Bachelor's Degree
Willingness to Travel: Occasionally
Why Join Us?
This director role is not just a job but a career opportunity in a city that offers a vibrant culture, beautiful landscapes, and a supportive community. Be a part of shaping the future of healthcare while enjoying a fulfilling career in Detroit, Michigan.
Apply now and embark on a rewarding journey with us. Together, we can achieve new heights in patient care and professional growth.