Director of Case Management - Utilization Management

Prime Healthcare•Inglewood, CA

1d•Onsite

About The Position

At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center is actively seeking new members to join its award-winning team! Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour STEMI certified emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, inpatient and outpatient rehab programs, and more. Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2022) for hospital safety from The Leapfrog Group. For more information, visit www.centinelamed.com. Why Prime Healthcare? Centinela Hospital Medical Center; a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs.

Requirements

CA Registered Nurse
Bachelor's of Science in Nursing
Grandfathered prior to April 1, 2015. Minimum 5 years’ post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.
Minimum 5 years’ experience in a Case Management position.
Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
Experience and knowledge in basic to intermediate computer skills.

Nice To Haves

Current BCLS certificate preferred.
Knowledge of Milliman Criteria and InterQual Criteria preferred.

Responsibilities

Lead our dynamic Case Management Team consisting of Registered Nurses, Social Workers, and Clinical Coordinators.
Oversee all facets of utilization management, discharge planning, and care coordination to ensure patients receive timely, appropriate, and efficient care throughout their hospital stay.
Develop staff and systems to effectively operate a comprehensive Case Management Program.
Provide leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians.
Assess needs and plan, communicate and design services that are appropriate to the hospital mission and patient/family needs.
Integrate and coordinate services using continuous quality improvement tools.
The ideal candidate is a forward-thinking professional who thrives in a collaborative, fast-paced healthcare setting and is passionate about driving positive patient outcomes and reducing readmissions.