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Director, Case Management and Utilization Review

Vista Health System
Waukegan, IL Full Time
POSTED ON 1/6/2025 CLOSED ON 1/22/2025

What are the responsibilities and job description for the Director, Case Management and Utilization Review position at Vista Health System?

Responsible for providing the overall leadership, management & direction of Case Management operations and staff, and for producing successful outcomes and results. Directs and implements case management programs, including utilization review, intake and discharge planning, and managed care contracting and negotiation.  Manages the integration of social services/case management functions into the patient care, discharge, and home planning processes in coordination with other hospital departments, external service organizations, agencies and healthcare facilities. Utilizes advanced strategies and tactics to provide the highest level of service.

  • Licensed RN in the state of Illinois
  • Bachelor’s in Nursing (BSN) degree, Masters in Nursing, Health Care or Business Administration preferred
  • 5 -7 years of RN Case Management experience within a hospital, at least 3 of which in a leadership role
  • Excellent learning, thinking, communication, interpersonal, clinical, & organizational skills.
  • Must be action oriented & motivated to achieve success.
  • Solid knowledge of Joint Commission standards.
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