Lead Case Management Administrator

2 weeks ago


Inglewood, California, United States Prime Healthcare Full time

Position Overview

At Prime Healthcare, we pride ourselves on our unwavering commitment to quality, compassion, and community. We are currently seeking a dedicated professional to join our esteemed team at Centinela Hospital Medical Center, recognized as one of the top hospital systems in the United States.

Centinela Hospital Medical Center has a rich history of nearly a century of service to the communities of Inglewood and the greater Los Angeles area. As a 362-bed acute-care facility, we are renowned for our excellence in patient safety and quality, consistently ranking in the top 5% nationally. Our comprehensive services include a 24-hour emergency department, primary stroke center, orthopedic care, advanced cardiac services, critical care, and a robust robotics surgery program.

Key Responsibilities

The Manager of Case Management plays a crucial role in the development and management of a comprehensive Case Management Program. This position involves:

  • Providing leadership and oversight to a team of case managers, social workers, and utilization review professionals.
  • Assessing patient needs and designing services that align with the hospital's mission and the needs of patients and their families.
  • Integrating and coordinating services while utilizing continuous quality improvement methodologies.
  • Ensuring quality and resource management for all patients from admission through the continuum of care.
  • Conducting thorough reviews of medical records to assess medical necessity and the intensity of services provided.

Qualifications

Required:

  • Current licensure as a clinician in the state.
  • A minimum of 5 years of post-graduate experience from an accredited school of Social Work for Licensed Clinical Social Workers.
  • At least 5 years of experience in a Case Management role.
  • Strong analytical skills for problem identification and data evaluation.
  • Proficiency in basic to intermediate computer skills.

Preferred:

  • Certification in Case Management, or a degree in a related field.
  • Current Basic Life Support (BCLS) certification.
  • Familiarity with Milliman and InterQual Criteria.

Prime Healthcare offers a competitive compensation package and a comprehensive benefits program that allows employees to customize their benefits to meet individual needs. Our Total Rewards package includes paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and various voluntary benefits. Compensation for this role is estimated to be competitive, based on experience, education, and other relevant factors.


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