Medical Management Director jobs in Oklahoma

Medical Management Director directs and oversees the operations and strategic planning of the organization's medical management initiatives and programs. Establishes case management, utilization review, quality and outcome management, and community education programs to provide high quality, cost effective health care services. Being a Medical Management Director develops and implements clinical guidelines for care designed to improve outcomes while managing costs. Requires a bachelor's degree. Additionally, Medical Management Director typically reports to top management. The Medical Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Medical Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Director of Case Management
  • Southwestern Medical Center
  • Lawton, OK OTHER

  • Description

    Duties and Responsibilities 

           Oversight of the Facility’s Case Management team to ensure compliance with standards of practice and other regulatory requirements related to care management and utilization review.

           Develop and foster effective collaboration between Case Management Departments, Medical Staff, corporate and facility leaders to ensure an integrated approach to providing care while fulfilling the hospital's goals and objectives. 

           Display an ability to work effectively within the health system's decision making and organizational structures.

           Work closely with providers as well as internal and external physician advisors for utilization review and management activities

           Coordinate all UM Committee activities to ensure compliance with meeting frequency and documentation of activity and outcomes

           Work collaboratively with Revenue Cycle teams and participates in task force meetings related to medical necessity audits and denials.

           Participate in appeals processes and work collaboratively with vendors to ensure the effectiveness and timeliness of appeals

           Analyze length of stay and readmissions data and incorporate measures with Operations team members, Corporate Case Management Directors and other facility leaders to ensure goals are met

           Introduce evidenced based practices geared to improve case management and transitions

           Conduct regular staff meetings to review pertinent Federal and State regulatory requirements, emerging internal and external trends, and provide general training for staff


    Qualifications

    II. Position Requirements:

     

    A.  Licensure/Certification/Registration:

    Applicants with the following licensure may be considered:  Oklahoma RN

               

    B.  Education:     BSN preferred, Registered nurse is required. Certification in Case Management or Utilization Review is preferred

     

    Skills

          Demonstrated leadership and complex organizational management skills

          Excellent management, problem solving, team building & organizational skills

          Familiarity with Federal & State regulations related to case management discharge planning.

          Knowledge of integrated discharge planning practices and resources available to patients

          Demonstrated knowledge of RACs, MACs and the Medicare appeals process

          Ability to work with Administration, Physicians, and staff in multiple settings

          Ability to compile reports and interpret data

          Ability to prepare and administer presentations

    Ability to interpret and apply InterQual criteria

     

    Experience:   A minimum of 5 years experience in case management, discharge planning, and/or utilization review in an inpatient acute care setting. Strong clinical background is preferred.

  • 18 Days Ago

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Director-Case Management
  • Southwestern Medical Center
  • Lawton, OK OTHER
  • DescriptionDuties and Responsibilities • Oversight of the Facility’s Case Management team to ensure compliance with standards of practice and other regulatory requirements related to care management a...
  • 1 Month Ago

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Nurse Director Medical Surgical
  • Clinical Management Consultants
  • Chickasha, OK FULL_TIME
  • An exciting opportunity with an up-and-coming Medical Center has just presented itself for a High Energy Nurse Director Medical Surgical. The Medical Center is located in Southern Oklahoma with Wichit...
  • 3 Days Ago

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Medical Surgical Services Nurse Director
  • Clinical Management Consultants
  • Duncan, OK FULL_TIME
  • A beloved medical center just north of the Texas/Oklahoma border is actively seeking a strong, experienced Medical Surgical Services Nurse Director to join their outstanding leadership team! Reporting...
  • 1 Month Ago

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Director of Care Management
  • Clinical Management Consultants
  • Norman, OK FULL_TIME
  • A new and exciting opportunity for a Director of Care Coordination has just become available at a 200 bed, highly awarded hospital in Southern Oklahoma! Come join a leading healthcare organization com...
  • 24 Days Ago

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Director of Medical Imaging and Diagnostics
  • Stillwater Medical
  • Stillwater, OK FULL_TIME
  • Stillwater Medical is looking for a new#leader to join our team as the Director of Medical Imaging.## # Key attributes for success in this position: Effective organizational skills and ability to mana...
  • 12 Days Ago

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Managing Director
  • SpartaCraft
  • Connelly Springs, NC
  • Job Description Job Description SpartaCraft, a contract wood products and finishing company in Connelly Springs, NC is l...
  • 3/28/2024 12:00:00 AM

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Managing Director
  • Chapman Associates, Inc.
  • Chapman Associates is a Mergers & Acquisitions association focused on middle-market strategic acquisitions on the buy an...
  • 3/28/2024 12:00:00 AM

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Case Management Director
  • Clinical Management Consultants
  • Plainview, TX
  • An award winning medical center is searching for a strong, experienced Case Management Director. Our team is excited to ...
  • 3/25/2024 12:00:00 AM

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Managing Director / Senior Managing Director - Debt Advisory
  • Oberon Securities, LLC
  • New York, NY
  • Oberon Securities, based in New York City, is seeking experienced Managing Directors with expertise raising asset, cash ...
  • 3/25/2024 12:00:00 AM

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Managing Director Relationship Manager-MMB
  • First Citizens Bank
  • Santa Monica, CA
  • Overview: First Citizens Middle Market Banking delivers a range of financial solutions to midsize clients through a rela...
  • 3/25/2024 12:00:00 AM

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Managing Director
  • Transamerica Premier Life Insurance Company
  • Nashville, TN
  • The Managing Director is responsible for growing the business of the District Office by developing new quality sales, co...
  • 3/25/2024 12:00:00 AM

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Managing Director
  • Artech L.L.C.
  • Fremont, CA
  • Artech is currently looking to hire an experienced Managing Director to join our expanding team in Fremont, CA (Hybrid)....
  • 3/25/2024 12:00:00 AM

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Managing Director
  • Selby Jennings
  • Chicago, IL
  • Join a dynamic and growing team at our Client; A premier financial services firm specializing in middle-market transacti...
  • 3/24/2024 12:00:00 AM

Oklahoma is the 20th-largest state in the United States, covering an area of 69,899 square miles (181,040 km2), with 68,595 square miles (177,660 km2) of land and 1,304 square miles (3,380 km2) of water. It lies partly in the Great Plains near the geographical center of the 48 contiguous states. It is bounded on the east by Arkansas and Missouri, on the north by Kansas, on the northwest by Colorado, on the far west by New Mexico, and on the south and near-west by Texas. Much of its border with Texas lies along the Southern Oklahoma Aulacogen, a failed continental rift. The geologic figure defi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Management Director jobs
$141,882 to $190,003

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