Amtex Systems Inc is an information technology and talent solutions company offering talent and BI consulting to the companies in US for over 20 years.
Our solutions are designed to fill resource gaps, by providing the right candidates who deliver value to the organization. Our propensity to nurture and build strong relationships with our clients helps us better understand their business demands and gives us the ability to provide services that are on time and rise above the rest.
Our client is seeking a passionate and experienced
Nurse Director, Case Management to join our team in San Ramon, California.
About The Client
Our client is a 123-bed, acute-care hospital, primary stroke center, and cardiac heart surgery hospital serving the San Ramon Valley and surrounding communities since 1990. They are committed to providing comprehensive inpatient and outpatient services with a personalized touch and patient-centered philosophy.
The Opportunity
In this leadership role, you will play a pivotal role in ensuring the efficient and effective delivery of case management services within our organization. You will be responsible for managing department operations, leading utilization management initiatives, overseeing patient transitions, and fostering collaboration with physicians and post-acute providers.
Key Responsibilities
- Manage department operations to optimize service delivery and maximize reimbursement.
- Implement and oversee the hospital Utilization Management Plan, leveraging data-driven insights to improve utilization performance.
- Ensure medical necessity and revenue cycle processes comply with CMS regulations and hospital policies.
- Facilitate timely and effective patient transitions to support efficient patient throughput.
- Develop and implement processes to minimize payer disputes.
- Provide physician education and feedback on hospital utilization.
- Manage and develop relationships with post-acute care providers.
- Ensure adherence to state and federal regulations, as well as TJC accreditation standards.
Qualifications
- Bachelor's degree in Business, Nursing, or Healthcare Administration (RN); Master's degree in Social Work (MSW) considered.
- Master's degree in Nursing (MSN), Business Administration (MBA), Social Work (MSW), or Health Administration (MHA) strongly preferred.
- Minimum 3 years of experience in acute hospital case management or healthcare leadership.
- Preferred: 5+ years of experience leading case management teams across multiple healthcare settings.
- Must be a Registered Nurse (RN) or hold a Licensed Clinical Social Worker (LCSW) or Licensed Master Social Worker (LMSW) license, with active licensure in California.
- Certified Case Manager (ACM) certification a plus.
Benefits - Competitive salary range: $180,000 - $230,000
- Relocation assistance available
- Comprehensive benefits package including:
- 401(k) with a 50% match up to 6% of pay
- Employee stock purchase plan
- Flexible spending accounts
- Medical, dental, vision, behavioral health, and telemedicine coverage
- Employee assistance program (EAP)
- Paid time off, long-term and short-term disability plans
- Tuition assistance, student loan assistance, certification support, and online educational programs
Join our Team!
If you are a passionate leader with a proven track record in case management and a commitment to patient-centered care, we encourage you to apply!
JOB # 83224557
Please note: While this job description is intended to accurately reflect the current needs of the client, we reserve the right to revise it as necessary.