Director of Care Coordination

3 days ago


Los Angeles, California, United States healthcarerecruitmentpartners Full time
Director of Utilization Management Job Description

The Director of Case Management and Utilization Review is responsible for overseeing the Case Management and Utilization Review program. This role involves developing and managing programs that emphasize appropriate admissions, concurrent and retrospective review of care, and other integrated functions such as Discharge Planning, Case Management, Utilization Review, Transportation coordination, and Care Coordination.

Key Responsibilities:
  • Acts as a resource to the medical administrative staff and external regulatory bodies.
  • Directs the operations of outside referrals/transportation services when necessary.
  • Serves as contract liaison on issues pertaining to new or existing contracts, outside vendors.
  • Coaches, trains, and disciplines staff to ensure smooth operations in Utilization Management.
  • Provides overall direction, design, development, implementation, and monitoring of Utilization programs to agencies in all issues.
  • Analyzes and reports significant Utilization trends, patterns, and appropriate departmental and medical staff committee.
Qualifications:
  • Director of Case Management experience in an acute care setting.
  • Bachelor of Science in Nursing required.
  • Master's Degree preferred.
  • CCM or ACM preferred.
  • Current California RN License required.
  • Demonstrated interpersonal, negotiation, and leadership skills.

This is a great opportunity for a seasoned healthcare professional to join our team at healthcarerecruitmentpartners and make a meaningful impact in the field of Utilization Management.



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