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Los Angeles, CA

LOCATION, Los Angeles, CA
Facility: Physician-owned heart hospital

The Director of Case Management is a working case manager who is responsible for the development of staff and systems to effectively operate a comprehensive Case Management/Utilization Review plan.
Provides leadership and supervision to case managers, clinical documentation specialists, social worker(s) and case management admininistration.
  • 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.
  • Manages the utilization of resources and discharge process of all inpatients. Maintains continuity and coordination of all the various disciplines involved throughout the patient’s continuum of care including readmission.
  • Provides education to staff/physicians/patients/families related to implementation of case management initiatives.
  • Provides leadership for the Utilization Review Committee and processes, including active collaboration with the CM/UR Physician Advisor.
  • Provides expertise and oversight in complex patient appeals and denials. Maintains and enhances relationships with referral and payor sources and assures quality care/outcomes while complying with various third party guidelines.
  • Graduation from a program of nursing required. BSN preferred.
  • Current CA Registered Nurse license or licensure from a state within the Nursing Compact.
  • Minimum of three (3) years clinical experience. Cardiovascular nursing experience preferred.
  • Two years of case management experience preferred.
SALARY: $130,000
CONTACT: Michael Zimmer, Director
Finance, Administration and Nursing Executive Search
The Hutton Group, Inc.
617-297-2898 617-217-1737(cell)
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