Director, Care Management - Full Time - Day Shift

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

Job Description

Centered in the heart of San Joaquin County, Adventist Health Lodi Memorial has been one of the area's leading healthcare providers since 1952. We are comprised of a 190-bed hospital, 17 medical offices, home care services, comprehensive cancer care and a vast scope of award-winning services located throughout Lodi and the surrounding areas. Lodi is known for its small-town charm, extensive vineyards and delicious local restaurants and bakeries. The allure of Lodi's close-knit community is complimented by its proximity to major metropolitan cities in the Bay Area and Sacramento, as well as a quick drive to Lake Tahoe or the Northern California coast.

Job Summary

Direct function and personnel of the care management department. Develops, manages, and oversees the annual care management budget. Prepares and evaluates monthly, quarterly, and annual reports of the department's functions. Monitors and reports on changes in Medicare regulations and documentation issues to physicians and others as needed. Maintains relationships and contractual oversight with key stakeholders, local, state, and federal agencies.

Job Requirements

Education and Work Experience:

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

Licenses/Certifications

• Registered Nurse (RN), Medical Degree (MD) or (DO) and currently licensed to practice, without restriction, in the State of California or Licensed Clinical Social Worker (LCSW): Required
• Licensed Master Social Worker (LMSW) - State Board: Preferred
• Registered Nurse (RN), Licensed Clinical Social Worker (LCSW) Medical Degree (MD) or (DO) and currently licensed to practice, without restriction, in the State of California: Required

Essential Functions

• 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. Maintains working relationships with local, state, and federal agencies.
• Performs other job-related duties as assigned.

Organizational Requirements

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

About Us

Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

JOB INFO

Job Identification : 75187

Job Category : Director

Posting Date : 2026-11-03T00:49:53+00:00

Locations : Lodi, CA, United States

Assignment Category : Full-time regular

Pay Range : The estimated base pay for this position is $153,251 to $229,877. Additional individual compensation may be available for this role through differentials, extra shift incentives, bonuses, etc. Base pay is only a portion of the total rewards package, and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information.

Hiring Department : RevCycle - Care Management

Shift Length : 8 Hours