Director Case Management

Trinity-Health   •  

Fresno, CA

Industry: Healthcare


5 - 7 years

Posted 47 days ago

Reporting to the Chief Medical Officer, Executive Management, this position is responsible for managing the utilization of resources and discharge process of all inpatients as well as selected outpatients for effective and proper utilization of beds and services to ensure quality while maximizing reimbursement. The position is responsible for the ongoing operations, short and long term planning, and development and articulation of the vision of the service. The Director is responsible for development, management and utilization of financial, material, and human resources; strategic planning; and integrated program development within the service. This position is also responsible to oversee the operations of the Social Services department, Clinical Documentation Specialists, and the Bundled Payment Care Initiative (BPCI) program.


1. Bachelors Degree in a related field is required. Masters Degree in related field is preferred.
2. Current licensure as a Registered Nurse in the State of California is required. Clinical professionals currently licensed outside the State of California will be provided six (6) months from date of hire to obtain equivalent California state licensure.
3. At least five years recent clinical experience in an acute care setting is required.
4. At least five years utilization review, discharge planning and/or case management experience is required.
5. Knowledge and/or familiarity with utilization review processes and guidelines, community resources, outside professional agencies, federal and state regulations governing hospital and home care as well as understanding the financial structure of health plans and
delivery systems is strongly preferred.
6. Current American Heart Association (AHA) Healthcare Provider CPR card is required.