Carondelet Health Networkis committed to providing Southern Arizonans with a full spectrum ofhigh-quality, cost-efficient health care. Our top priority is improving thehealth of all those we serve, and has been serving and caring for the Tucsonand Southern Arizona community for over 130 years. We invite you to share inthis commitment. No matter what position you seek, your experience, skills andcompassion are greatly valued. We count on the strengths of each individual tobring our mission of care to the patients and families of Southern Arizona.
Established in 1961, St.Joseph�s Hospital is a premiere medical campus serving Tucson and theSouthwest. St. Joseph�s is home to the Carondelet Neurological Institute andthe Carondelet Joint Replacement Center. The 486-bed facility is an accredited Chest Pain Center,has been recognized by the American Heart and Stroke Association with a Getwith the Guidelines Award for stroke care, and has nationally-certified Cardiacand Pulmonary Rehabilitation Programs. Here you�ll find one of the region�s most comfortable labor anddelivery units as well as high-quality care and customer service in programssuch as cardiology, orthopedics, oncology, wound care, stroke, diabetes,emergency medicine and rehabilitation.
The individual in this position has overallresponsibility for hospital utilization management, transition management andoperational management of the Case Management Department in order to promoteeffective utilization of hospital resources, timely and accurate revenue cycleprocesses, denial prevention, safe and timely patient throughput, andcompliance with all state and federal regulations related to case managementservices. This position integrates national standards for case management scope ofservices including: Utilization Management supporting medical necessity and denial prevention Transition Management promoting appropriate length of stay, readmissionprevention and patient satisfaction Care Coordination by demonstrating throughput efficiency while assuring care isthe right sequence and at appropriate level of care Compliance with state and federal regulatory requirements, TJC accreditationstandards and Tenet policy Education provided to physicians, patients, families and caregivers
The individual�s responsibilities include thefollowing activities:
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 and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet 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
Participate in management of post-acute provider network
Ensure compliance with state and federal regulations and TJC accreditation standards, and other duties as assigned.
MINIMUM EDUCATION: Bachelor's Degree in Nursing
PREFERRED EDUCATION: MSN.
MINIMUM EXPERIENCE: Five years experience in nursing management in ahospital setting with three years supervisory experience required.
PREFERRED EXPERIENCE: Minimum two years experienceas Case Management Director in an acute care hospital
SPECIAL SKILLS: Must be able to utilize independent decision-makingskills in a wide variety of situations. Requires a high degree of accuracy inthe performance of varied responsibilities. Personal computer skills required.Frequent contact with employees, physicians, customers, community individualsand volunteers. Must be self-motivated to complete work in a timely manner tomeet deadlines. Computer skills required.
Job: Managers and Directors
Primary Location: Tucson, Arizona
Facility: Carondelet St. Joseph's Hospital
Job Type: Full-time
Shift Type: Days
Employment 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.
Internal Number: 2005028677
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