NHS Solutions has a fantastic opportunity for an experienced Interim Leader in Case Management. The staff includes Bachelor’s and Master’s level trained nurses and social workers, as well as, clinical and support staff. The responsibilities of the Interim director of Case Management include but are not limited to:

  • Serving as the leader of the Department of Clinical Resource Management and Social Work, reporting to the Chief Medical Officer/Associate Executive Director
  • Conducting Utilization Review; managing key components of Patient Progression, including Discharge Planning and assuring that patients and their families are linked to appropriate community resources and land transportation resources; Appeals Management, working with the Physician Advisor in communicating with external payers and internal physicians
  • Working in tandem with the Business Office and closely with the Office of the Chief Financial Officer assuring that reimbursement is secured for all patient days to the extent possible
  • Insuring that all Clinical Resource Management and Social Work processes are conducted in compliance with all legal and regulatory requirements
  • Recruiting, hiring, mentoring and retaining staff
  • Developing and managing the department budget
  • Scheduling of personnel, and the development and management of the Case Management information systems
  • Serving as the departmental liaison for the hospital Clinical Effectiveness and Quality Improvement (CEQI) program and initiatives
  • Interacting routinely with the other Entity Directors and working with the Office of Managed Care in third party payer issues management efforts

Key Qualifications:

  • Bachelor’s degree in health related field
  • Master’s Degree in health care or business
  • Active state RN license
  • A minimum of five (5) years’ experience in a management position in hospital operations and utilization review or case management

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    Behavioral HealthCardiac Services/Cath LabCase ManagementEmergency Rm (ER)/ Emergency Dept (ED)Health Info Mgmt (HIM)/Med RecordsICU/CCULaboratoryMed-SurgOncologyPatient Care/Nursing ServicesPost Anesthesia Care Unit (PACU)QualityRisk ManagementSurgical Services/OR/PeriopWomen & Child Svcs/OB/Labor & DelivOther