Director of Case Management - Hospital Group

Director of Case Management - Hospital Group

We are excited to offer an exceptional opportunity for a seasoned Director of Case Management at our dynamic healthcare organization, stationed in Modesto, CA. This pivotal role encompasses overseeing the strategic execution and operational management of Case Management across multiple hospital sites. The Director ensures robust utilization management, effective patient transitions, compliance with regulatory requirements, and optimization of revenue cycle processes. This position provides a strategic advantage in enhancing patient care quality while ensuring financial sustainability through advanced resource management, all within a supportive and forward-thinking environment.

Salary: $200,000 - $240,000 per year

Essential Duties and Responsibilities:

• Strategically lead Group Hospital Directors of Case Management in enhancing care levels, optimizing length of stay, and managing payer authorizations.
• Develop and implement objectives aligned with the overarching strategic plans for Case Management and Utilization Review.
• Manage operations of Group Hospital Case Management and Utilization Review to deliver cost-effective and clinically competent care.
• Guide the selection, orientation, and onboarding of new Hospital Directors of Case Management.
• Utilize data-driven decision-making to maintain operational excellence and compliance with regulatory standards.
• Address potential issues proactively, mitigating risks and enhancing system efficiencies.
• Communicate strategic visions and operational changes effectively across all organizational levels.
• Initiate, implement, and monitor the hospital's Case Management policies, ensuring adherence to regulatory requirements.
• Drive utilization performance improvements using data analytics to inform hospital management plans.
• Optimize patient throughput and ensure comprehensive reimbursement strategies for provided medical services.

Minimum Position Qualifications:

• Required: Bachelor’s degree in Nursing, Social Work, Health Care Administration, or Business.
• At least 5 years of leadership experience in hospital Case Management.
• Must possess an active RN or LCSW/LMSW license as per state regulation.

Preferred Qualifications:

• Advanced degree in a related healthcare field or business administration.
• Over 5 years of multi-site case management leadership within an acute hospital setting.
• Experience in business planning, healthcare project management, and strategic development.
• Accredited Case Manager (ACM) certification is highly desirable.

Skills:

• Proven organizational and leadership skills.
• Strong verbal and written communication capabilities.
• Ability to manage a diverse team in a high-pressure environment.
• Advanced critical thinking, analytical, and problem-solving skills.
• High level of computer literacy and data analysis proficiency.

Benefits:

• 401(k) with matching contributions.
• Comprehensive medical, prescription, dental, vision, and behavioral health coverage.
• Generous paid time off policies including vacation, sick leave, and holidays.
• Tuition reimbursement programs to support ongoing education and professional development.
• Additional perks such as life insurance, supplemental health plans, employee discounts, and more.