Do you have the career opportunities you want in your current role? We have an exciting opportunity for you to join the nation's largest provider of healthcare services as a*Director (RN) Case Management. *
We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe in our team and your ability to do excellent work with us. Your benefits include 401k, PTO, medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program, employee stock purchase program and student loan repayment. We would love to talk to you about this fantastic opportunity.
HCA Houston Healthcare Medical Center Houston, TX
Director (RN) Case Management
HCA Houston Healthcare Medical Center is a 444-bed acute care hospital in the heart of Houstons museum district. Established in 1975, the hospital has been serving Houston for more than 40 years. It provides a wide range of medical services, including cardiology, bariatrics, orthopedics, neurology, emergency care and more.
The hospital is affiliated with HCA Houston Healthcare, part of the HCA Healthcare Gulf Coast Division. The division is a comprehensive network of hospitals, outpatient surgery centers, emergency centers and diagnostic imaging facilities in greater Houston, Corpus Christi and South Texas. Facilities include: 17 hospitals, nine ambulatory care centers, 13 off-campus emergency centers, and a regional transfer center.
What you will do in this role:
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.
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 HCA policy
- Education provided to physicians, patients, families and caregivers
The individuals responsibilities include the following activities:a) manage department operations to assure effective throughput and reimbursement for services provided, b) lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement, c) ensure medical necessity review processes are completed accurately and in compliance with CMS regulations and HCA policy, d) ensure timely and effective patient transition and planning to support efficient patient throughput, e) implement and monitor processes to prevent payer disputes, f) develop and provide physician education and feedback on hospital utilization, , g) ensure compliance with state and federal regulations and TJC accreditation standards, and h) other duties as assigned.
What qualification you will need:
- Registered Nurse license
- MSN preferred. Accredited Case Manager (ACM) preferred.
- At least two years acute hospital case management leadership experience. Five years acute hospital case management experience preferred.
HCA Healthcare ranks on Fortunes list of Most Admired Companies for three consecutive years and HCA ranks 63rd on the fortune 500 list. In addition Ethisphere named HCA as one of the Worlds Most Ethical Companies. We want you to join our tradition of excellence. Intrigued? Wed love to hear from you.
If you find this opportunity compelling, we encourage you to apply. We promptly review all applications. If you are highly qualified you will hear from one of our recruiters. We are actively interviewing so apply today!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Job: *Directors & Managers
Title: Director (RN) Case Management
Location: Texas-Houston-HCA Houston Medical Center
Requisition ID: 26925-141928