What are the responsibilities and job description for the Director of Case Management - Utilization Management position at Prime Healthcare Services?
Overview
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.
Our Total Rewards package includes, but is not limited to:
- Paid Time Off
- 401K retirement plan
- Outstanding Medical
- Dental
- Vision Coverage
- Tuition Reimbursement
- Many more Voluntary Benefit Options!
Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time.
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf
Responsibilities
The Director of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs. Integrates and coordinates services using continuous quality improvement tools.
Qualifications
EDUCATION, EXPERIENCE, TRAINING
Required qualifications:
1. CA Registred Nurse
2. Bachelor's of Science in Nursing3. Grandfathered prior to April 1, 2015. Minimum 5 years’ post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.4. Minimum 5 years’ experience in a Case Management position.5. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.6. Experience and knowledge in basic to intermediate computer skills.
Preferred qualifications:
1. Current BCLS certificate preferred.2. Knowledge of Milliman Criteria and InterQual Criteria preferred.
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. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $108,160.00 to $163,800.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Salary : $108,160 - $163,800
