District Manager, Clinical Resource Management

Palomar Health; Escondido (CA); On-site; USD 116,000 - 183,000; Full time

Job summary

Palomar Health in Escondido, CA is seeking a Manager of Clinical Resource Management (Case Management/Utilization Review) to lead the Care Management team and coordinate patient care across departments. The role focuses on optimizing clinical outcomes and financial performance while maintaining high quality care and efficient discharge planning.

You will supervise case managers and social workers, manage staffing and performance, and work with payers and providers to ensure compliant and

Qualifications

• Bachelor's Degree in Nursing or related healthcare field required.
• Master's degree preferred.
• Minimum 2+ years recent management/leadership experience.
• 4+ years experience in Acute Hospital Case Management and/or Utilization Review.
• American Heart Association BLS - Healthcare Provider certification required.
• Certified Case Manager certification preferred.
• Current CA RN License required.

Responsibilities

• Oversee and coordinate clinical resource management, case management and utilization review.
• Supervise case managers and social workers; manage staffing and scheduling.
• Collaborate with hospital departments and payers to ensure coordinated care.
• Analyze patient care and financial outcomes; present findings to leadership.
• Support discharge planning and ensure compliance with policies and standards.

Skills

Leadership

Staff coordination

Communication skills

Analytical thinking

Problem solving

Education

Bachelor's Degree in Nursing or related healthcare field

Master's Degree in Healthcare related field

Tools

MS Windows

Excel

Access

Word

PowerPoint

Internet

Email

Job description

Palomar Health in Escondido, CA is seeking a Manager of Clinical Resource Management (Case Management/Utilization Review) to lead the Care Management team and coordinate patient care across departments. The role focuses on optimizing clinical outcomes and financial performance while maintaining high quality care and efficient discharge planning.

You will supervise case managers and social workers, manage staffing and performance, and work with payers and providers to ensure compliant and