Director, Utilization & Social Work Services

CHA Hollywood Presbyterian Medical Center; Los Angeles (CA); Presencial; USD 120 000 - 160 000; Tempo integral

Resumo da oferta

CHA Hollywood Presbyterian Medical Center in Los Angeles seeks a seasoned leader to oversee hospital utilization management and transition operations. The role drives medical necessity, denial prevention, and efficient patient throughput across the Case Management Department.

Responsibilities include coordinating care, ensuring CMS compliance, and educating physicians on utilization strategies, all while aligning with regulatory standards and organizational goals.

Qualificações

• Excellent verbal and written communication.
• Ability to work in a union environment.
• 3 years of acute hospital case management or healthcare leadership experience.
• Demonstrated organizational skills.
• Ability to lead and coordinate a diverse group in a fast-paced environment.
• Critical thinking and problem solving skills.
• Computer literacy.

Responsabilidades

• Utilization Management supporting medical necessity and denial prevention.
• Transition Management promoting appropriate length of stay and readmission prevention.
• Care Coordination ensuring throughput efficiency and appropriate level of care.
• Compliance with CMS regulations and HPMC policy.
• Lead the implementation and oversight of the Utilization Management Plan.
• Educate physicians on hospital utilization and feedback.

Conhecimentos

Communication

Leadership

Organizational skills

Critical thinking

Written communication

Formação académica

Bachelor degree in Business, Nursing or Health Care Administration

Active RN or LCSW/LMSW license

Master's in Social Work or MBA

Descrição da oferta de emprego

CHA Hollywood Presbyterian Medical Center in Los Angeles seeks a seasoned leader to oversee hospital utilization management and transition operations. The role drives medical necessity, denial prevention, and efficient patient throughput across the Case Management Department.

Responsibilities include coordinating care, ensuring CMS compliance, and educating physicians on utilization strategies, all while aligning with regulatory standards and organizational goals.