23053006 – Interim Director Case Management

NHS Solutions has a exciting opportunity for an Interim Director of Case Management. Job responsibilities include:

• Manage department operations to assure effective throughput and reimbursement for services provided
• Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement
• Ensure medical necessity review processes are completed accurately and in compliance with CMS regulations and policy
• Ensure timely and effective patient transition and planning to support efficient patient throughput
• Implement and monitor processes to prevent payer disputes
• Develop and provide physician education and feedback on hospital utilization
• Ensure compliance with state and federal regulations and TJC accreditation standards
• Other duties as assigned