RN OR Rotating Shift FT Sign on Bonus available

Company: DMC Sinai-Grace Hospital
Location: Warren
Posted on: September 20, 2023

Job Description:

This position is a market position and will support St. Vincent Hospital in Worcester, MA; Metrowest Medical Center with hospitals in Framingham and Natick, MA. Metrowest Medical Center is the largest community health care system between Worcester and Boston. MetroWest Medical Center is committed to providing high quality, comprehensive care, at a location close to home. The 307-bed regional healthcare system includes Framingham Union Hospital, Leonard Morse Hospital in Natick and the Metrowest Wellness Center. Metrowest Medical Center has been named to the 2019 America's 100 Best Hospitals List by Healthgrades.
Position Summary:The individual in this position has overall responsibility for hospital utilization management, transition management, and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and 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 Tenet policy; and Education provided to physicians, patients, families, and caregiversThe individual's 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 and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet 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) participate in management of post-acute provider network, h) ensure compliance with state and federal regulations and TJC accreditation standards and i) other duties as assigned.
Onboarding Process: Please be advised that candidates must successfully complete a background check and pre-employment health screening which includes a drug screen.
Qualifications:Required: Bachelor's degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSWPreferred: MSN, MBA, MSW, or MHARequired: 3 years of acute hospital case management or healthcare leadership experience Preferred: 5 years of acute hospital case management leadership multi-site experienceRequired: Registered Nurse or LCSW/LMSW license. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN or LCSW/LMSW license for state(s) covered.Preferred: Accredited Case Manager (ACM)Lift/position up to 25 lbs. Push/pull up to 25 lbs. of force. Frequent sitting. Moderate standing, walking, reaching, stooping, and bending. Manual dexterity, mobility, touch, auditory to perform all the related duties of the position.2305039232Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

Keywords: DMC Sinai-Grace Hospital, Warren , RN OR Rotating Shift FT Sign on Bonus available, Healthcare , Warren, Michigan