Demo

Director of Case Management - Utilization Management

Prime Healthcare Services
Inglewood, CA Full Time
POSTED ON 1/8/2025 CLOSED ON 1/16/2025

What are the responsibilities and job description for the Director of Case Management - Utilization Management position at Prime Healthcare Services?

Location US-CA-Inglewood ID 2025-189094 Category Director Position Type Full Time Shift Days Job Type Exempt

Overview

Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for nearly 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 emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, robotics surgery program, inpatient and outpatient rehab programs, labor and delivery, and more.

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community!

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 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.

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.

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. 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. Licensed clinician in your state. 2. Grandfathered prior to April 1, 2015. Minimum 5 years’ post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.3. Minimum 5 years’ experience in a Case Management position.4. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.5. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

1. Certification in Case Management, BS or BSN or related field preferred.2. Current BCLS certificate preferred.3. 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

Travel RN -Case Management Utilization Review
Forhyre -
Los Angeles, CA

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