Director of Case Management - Utilization Management

Centinela Hospital Medical Center•Inglewood, CA

91d•$108,160 - $163,800

About The Position

Centinela Hospital Medical Center is seeking a Director of Case Management to lead its Case Management Team, including Registered Nurses, Social Workers, and Clinical Coordinators. The Director oversees utilization management, discharge planning, and care coordination to help ensure patients receive timely, appropriate, and efficient care throughout their hospital stay. The Director develops staff and systems to operate a comprehensive Case Management Program and provides leadership and supervision to case managers, social workers, case management coordinators and discharge planners, utilization review coordinators, and utilization technicians. The role assesses needs and plans, communicates and designs services aligned with the hospital’s mission and patient and family needs, and integrates and coordinates services using continuous quality improvement tools. The preferred leadership style is forward-thinking and collaborative, with a focus on positive patient outcomes and reducing readmissions. The position is full-time, day shift. The estimated annual compensation range is $108,160 to $163,800; starting compensation is determined based on factors including skills, applicable experience, education, credentials, and licensure.

Requirements

California Registered Nurse license.
Bachelor of Science in Nursing.
Minimum five years’ experience in a Case Management position.
Analytical ability for problem identification and assessment and evaluation of data and statistics obtained from an ongoing review process.
Experience and knowledge in basic to intermediate computer skills.
For a Licensed Clinical Social Worker, minimum five years post-graduate experience from an accredited school of Social Work, with grandfathered status prior to April 1, 2015.

Nice To Haves

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

Responsibilities

Lead the Case Management Team, including Registered Nurses, Social Workers, and Clinical Coordinators.
Oversee utilization management, discharge planning, and care coordination.
Develop staff and systems to operate a comprehensive Case Management Program.
Provide leadership and supervision to case managers, social workers, case management coordinators and discharge planners, utilization review coordinators, and utilization technicians.
Assess needs and plan, communicate, and design services appropriate to the hospital mission and patient and family needs.
Integrate and coordinate services using continuous quality improvement tools.
Support positive patient outcomes and efforts to reduce readmissions.