About Us: Join a leading healthcare organization in Detroit, Michigan, where we are dedicated to providing exceptional patient care and fostering a supportive and positive work environment. As part of our team, you will play a pivotal role in shaping the future of healthcare in our community. Detroit is a city rich in culture, surrounded by the stunning Great Lakes, and offers a wide range of recreational activities and educational opportunities.

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Job Overview: We are seeking an experienced and dynamic Director of Case Management to lead our department. This role is instrumental in ensuring the delivery of high-quality, cost-effective care by managing department operations, utilization, transition management, care coordination, and education. The ideal candidate will possess a strong background in acute hospital case management leadership and a commitment to excellence.

Competitive Compensation: $106,000 - $135,000 based on experience. Comprehensive benefits package and possible relocation assistance available.

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Key Responsibilities:

Department Operations:

• Maintain an optimal staff mix to meet department goals.
• Implement staffing requests in line with recommendations and budget.
• Conduct departmental meetings and continual education for staff.
• Review competencies and develop action plans for improvement.

Utilization Management:

• Oversee medical necessity reviews to ensure proper patient care levels.
• Manage the submission of cases to Physician Advisor and utilization review processes.
• Advocate with payers for appropriate payment for services.

Transition Management:

• Guarantee the completion of transition plan assessments within 24 hours of admission.
• Ensure effective patient placement through electronic referral processes.

Care Coordination:

• Collaborate with healthcare teams to ensure timely patient care.
• Monitor the sequencing of consults, testing, and procedures for efficient delivery.

Education & Compliance:

• Provide education on medical necessity, documentation, and compliance.
• Ensure the department adheres to federal, state, and local regulations.

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Minimum Qualifications:

• Bachelor’s degree in Nursing or related health field; Master’s preferred.
• Current Michigan RN license.
• 3-5 years of acute hospital case management leadership experience.
• McKesson InterQual® experience preferred.
• Accredited Case Manager (ACM) certification is a plus.

Skills Required:

• Analytical and fiscal management abilities.
• Strong communication, teaching, and project management skills.
• Leadership skills with demonstrated experience.

Seniority Level: Director

Minimum Education: Bachelor's Degree

Willingness to Travel: Occasionally

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Why Join Us?

This director role is not just a job but a career opportunity in a city that offers a vibrant culture, beautiful landscapes, and a supportive community. Be a part of shaping the future of healthcare while enjoying a fulfilling career in Detroit, Michigan.

Apply now and embark on a rewarding journey with us. Together, we can achieve new heights in patient care and professional growth.