Care Management Director — Lead Patient Outcomes

Adventist Health; Lodi (CA); On-site; USD 153,000 - 230,000; Full time

Job summary

Adventist Health is seeking a Director of Care Management in Lodi, CA to lead the care management team and oversee the department's annual budget. The role involves ensuring compliance with Medicare regulations and coordinating with physicians and external agencies.

The position requires substantial leadership and clinical experience in discharge planning, utilization review, and case management within a hospital setting.

Qualifications

• Bachelor’s Degree or equivalent combination of education/related experience is required.
• Master's Degree preferred.
• Seven years' hospital discharge planning, utilization review, case management and social work experience preferred.
• Five years' leadership experience preferred.

Responsibilities

• Develops the care management team and motivates them to accomplish department goals and objectives.
• Develops, manages, and oversees the annual care management budget. Prepares and evaluates monthly, quarterly, and annual reports of the department's functions.
• Provides information regarding changes in Medicare regulations and documentation issues to physicians and others as needed.
• Analyzes and monitors utilization metrics and communicates findings as appropriate.
• Oversees accountability for on-site monitoring reviews by outside review organizations and third-party payers.
• Maintains relationships and contractual oversight with key stakeholders, onsite and enterprise-wide, including education and monitoring of utilization patterns.

Skills

Leadership

Discharge planning

Utilization review

Case management

Social work

Education

Bachelor’s Degree or equivalent combination of education/related experience

Master's Degree (Preferred)

Seven years' hospital discharge planning, utilization review, case management and social work experience (Preferred)

Five years' leadership experience (Preferred)

Job description

Adventist Health is seeking a Director of Care Management in Lodi, CA to lead the care management team and oversee the department's annual budget. The role involves ensuring compliance with Medicare regulations and coordinating with physicians and external agencies.

The position requires substantial leadership and clinical experience in discharge planning, utilization review, and case management within a hospital setting.