Director of Case Management & Care Coordination

Prime Healthcare; Olympia Fields (IL); On-site; USD 85,000 - 124,000; Full time

Job summary

Olympia Fields Hospital in Illinois is seeking a Director of Case Management (RN or LCSW) to lead Case Management, Utilization Review, Social Work, Care Coordination, and Discharge Planning, driving efficient resource use, patient throughput, and quality outcomes.

This full-time days role emphasises regulatory compliance, collaboration with physicians and payers, and performance improvement initiatives to optimize care pathways and reduce readmissions.

Qualifications

• Analytical ability for problem identification and data interpretation.
• Experience with case management processes and utilization review.
• Proficiency with basic to intermediate computer skills.

Responsibilities

• Lead Case Management, Social Work, Utilization Review, and Discharge Planning teams.
• Drive patient throughput, LOS optimization, and readmission reduction strategies.
• Partner with physicians, nursing, payers, and interdisciplinary teams to remove barriers to care.
• Monitor performance metrics and lead quality and process improvement initiatives.
• Ensure CMS, accreditation, regulatory, and payer compliance.

Skills

Analytical ability

Problem solving

Data analysis

Computer skills

Education

Licensed clinician in state (RN or LCSW)

MSW or related field

BSN or related field (preferred)

Tools

Milliman Criteria

InterQual Criteria

Job description

Olympia Fields Hospital in Illinois is seeking a Director of Case Management (RN or LCSW) to lead Case Management, Utilization Review, Social Work, Care Coordination, and Discharge Planning, driving efficient resource use, patient throughput, and quality outcomes.

This full-time days role emphasises regulatory compliance, collaboration with physicians and payers, and performance improvement initiatives to optimize care pathways and reduce readmissions.