Recognized for Excellence. Chosen for Caring.
Human Resources: 700 Lawn Avenue, Sellersville, PA 18960  |  215-453-4874
Director of Case Management
Full Time, Days - Mon-Fri, 8am-4:30pm with 24/7 accountability
Sellersville, PA 18960

Grand View Health, which includes Bucks County's first hospital, has provided residents of Bucks and Montgomery counties with comprehensive healthcare services since 1913. Now a century strong, Grand View offers a range of inpatient and outpatient care, particularly emphasizing the areas of surgery and orthopedics, women's and children's health, heart and vascular care, and cancer treatment. Our colleagues enjoy the best of both worlds by working for a high-quality, low-cost healthcare provider in a collaborative, community environment. Help us build this new era of wellness and lead our community to a healthier future.
 

Responsibilities

The Director of Case Management directs, plans, supervises, integrates and coordinates the GVH Case Management and Clinical Documentation Improvement programs. Oversees utilization management, denial management, care coordination, DC planning and social work in the acute care setting, as well as outpatient-related Case Management programs (ER, Healthy Beginnings, Medical Access Program, Outpatient Social Work). Oversees and is responsible for the performance of the Supervisor of Case Management, department staff, department functions and outcomes. Ensures organizational compliance with federal, state, payor and other entities for regulations and standards. Identifies, builds and directs strategic interventions and innovation to improve department, systems and organizational resource utilization to maximize quality-of-care transitions, clinical documentation and care coordination across the continuum while optimizing and securing revenue.

Requires 5 years as a Director/Manager/Supervisor of Acute Care Case Management. Strong knowledge of payor, government and vompliance regulations. Needs core knowledge base of clinical care coordination, DC planning, utilization management, social work, clinical documentation, compliance, reimbursement, managed care and change management. Proficient with Microsoft Office and case management software management/administration.
 

Qualifications

EDUCATION AND EXPERIENCE:
Master of Social Work degree from CSWE-accredited school of Social Work. Minimum of 5 years of progressively responsible hospital management positions related to case management is required. Working knowledge of managed care, care coordination, case management, social work, utilization management and clinical documentation improvement in an acute care setting is required. Sound knowledge of regulations and requirements for payors, federal, state and other entities is required.

OR

Associate's degree or diploma – RN. Minimum of 5 years of progressively responsible hospital management positions related to case management is required. Working knowledge of managed care, care coordination, case management, social work, utilization management and clinical documentation improvement in an acute care setting is required. Sound knowledge of regulations and requirements for payors, federal, state and other entities is required.

OR

BSN with a minimum of 5 years of progressively responsible hospital management positions related to case management is required. Working knowledge of managed care, care coordination, case management, social work, utilization management and clinical documentation improvement in an acute care setting is required. Sound knowledge of regulations and requirements for payors, federal, state and other entities is required/preferred.

OR

Master's degree in a related healthcare field. Minimum of 5 years of progressively responsible hospital management positions related to case management is required. Working knowledge of managed care, care coordination, case management, social work, utilization management and clinical documentation improvement in an acute care setting is required. Sound knowledge of regulations and requirements for payors, federal, state and other entities is required/preferred.

LICENSES AND CERTIFICATIONS:

  • Registered Nurse in PA – licensed, upon hire, required OR Social Worker, licensed upon hire, required.
Grand View Health is an equal opportunity employer.
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