Director Registered Nurse (RN) - Case Management

Job Description \n Tenet Massachusetts is seeking a Registered Nurse (RN) Case Management Director for a nursing job in Worcester, Massachusetts. Job Description & Requirements\n \n Specialty: Case Management \n Discipline: RN \n Duration: Ongoing \n Shift: days \n Employment Type: Staff \n \n \n This position is eligible for a $20,000 Sign-On Bonus \n 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 caregivers \n \n Manage department operations to assure effective throughput and reimbursement for services provided \n Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement \n Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy \n Ensure timely and effective patient transition and planning to support efficient patient throughput \n develop and provide physician education and feedback on hospital utilization \n other duties as assigned. \n \n \n Required:\n \n Education: Bachelor's degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW \n Experience: 3 years of acute hospital case management or healthcare leadership experience \n \n \n \n \n Licensure/Certification: \n \n Registered Nurse or LCSW/LMSW license. \n Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. \n Active RN or LCSW/LMSW license for state(s) covered. \n \n Preferred:\n \n Experience: 5 years of acute hospital case management leadership multi-site experience \n Education: MSN, MBA, MSW, or MHA \n Licensure/Certification: Accredited Case Manager (ACM) \n \n \n \n Tenet Massachusetts Job ID View phone number on click.appcast.io. Posted job title: Director - Case Management About Tenet Massachusetts\n \n Facilities: \n Saint Vincent Hospital – Worcester, MA \n MetroWest Medical Center – Framingham, MA \n Leonard Morse Hospital – Natick, MA (part of MWMC) \n \n MA - SVH \n \n Tenet’s Saint Vincent Hospital has been providing high-quality health care to Worcester and the surrounding communities for more than 125 years. At Saint Vincent Hospital, we believe you should have access to the treatments you need without having to travel far from home. We are proud to have been the first hospital in central Massachusetts to offer robotically assisted surgical procedures and minimally invasive, computer-assisted joint replacements. Among the distinctions that we have received include our designations as a Blue Distinction Center for \n Cardiac Services, Bariatric Surgery, and both Knee and Hip Replacement. We continue to be leaders in state-of-the-art treatments like our CyberKnife Radiosurgery, and our Cardiac Rehabilitation Program which offers a unique, specialized approach to overcoming heart health challenges. Healthgrades awarded Saint Vincent Hospital 1 in Cardiology in the state and one of America’s 100 Best Hospitals for Coronary Intervention in 2023 and 2024, which puts Saint Vincent Hospital in the top 5% of hospitals nationwide for coronary intervention. At Saint Vincent Hospital, you can grow your career skills through a wide range of specialties, and help support the overall health of our community. \n \n MA - MWMC \n \n Tenet’s MetroWest Medical Center has been serving the community since we opened as the first public medical facility in Framingham in 1893. MetroWest Medical Center is comprised of Framingham Union Hospital and Leonard Morse Hospital, a unique behavioral health specialty center located in Natick dedicated to the mental health of our community. At Framingham Union Hospital, you’ll find comprehensive health care services for your entire family including 24-hour \n emergency care, advanced cardiac care, high-tech cancer treatments, and advanced maternity care including our Special Care Level IIB nursery and high risky pregnancy care. MetroWest Medical Center was recognized by the Joint Commission with a Gold Seal of Approval, a symbol of quality that reflects our commitment to meeting performance standards and providing safe and effective patient care. Our skilled cardiac team has been recognized as one of Healthgrades’ America’s 100 best hospitals for Coronary Intervention and ranked among the top 5% in the nation for coronary interventional procedures in 2023. At MetroWest Medical Center, you can grow your career skills and be a vital member of our team dedicated to improving the health of our community. \n \n \n Benefits\n \n Medical benefits \n Dental benefits \n 401k retirement plan \n Sign-On bonus \n \naa415a4b-8b21-40fc-a65c-70d2b25ca29a