Senior Director, Care Management & Utilization

Adventist Health; Marysville (CA); On-site; USD 145,954 - 218,931; Full time

Job summary

Adventist Health in Marysville, CA is seeking a Director of Care Management to lead the care management department and oversee the annual budget. You will manage reporting, regulatory updates, and stakeholder relationships to ensure compliant and efficient operations.

The role requires RN/MD/LCSW licensure with significant leadership and hospital discharge planning experience, and offers a comprehensive benefits package within a faith‑based health system.

Qualifications

• 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

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.
• Performs other job-related duties as assigned.

Skills

Leadership

Budget management

Regulatory knowledge

Education

Bachelor’s Degree or equivalent

Master's Degree

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

Five years' leadership experience

Job description

Adventist Health in Marysville, CA is seeking a Director of Care Management to lead the care management department and oversee the annual budget. You will manage reporting, regulatory updates, and stakeholder relationships to ensure compliant and efficient operations.

The role requires RN/MD/LCSW licensure with significant leadership and hospital discharge planning experience, and offers a comprehensive benefits package within a faith‑based health system.