Director of Case Management - Utilization Management

Overview

At Centinela Hospital Medical Center
, our dedicated team of professionals is committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top‑15 hospital system in the United States, we are actively seeking new members to join our award‑winning team.

Centinela has been serving the communities of Inglewood and the wider Los Angeles area for 100 years. The 362‑bed acute‑care hospital features a 24‑hour STEMI‑certified emergency department, primary stroke center, orthopedic care, advanced cardiac services, critical care, inpatient and outpatient rehabilitation, and more. We are ranked in the top 5% nationally for quality and patient safety and have earned hundreds of national awards, including "100 Top Hospital" from Fortune/Merative and straight "A" scores (2018‑2022) from The Leapfrog Group.

Prime Healthcare offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that allows employees to tailor benefits to their individual needs.

• Paid Time Off
• 401(k) retirement plan
• Outstanding Medical coverage
• Dental
• Vision coverage
• Tuition reimbursement
• Many more voluntary benefit options

Benefits may vary based on collective bargaining agreement requirements and/or employment status (full‑time or part‑time).

We are seeking a strategic and compassionate Director of Case Management to lead our dynamic Case Management Team of Registered Nurses, Social Workers, and Clinical Coordinators. The Director will oversee utilization management, discharge planning, and care coordination to ensure patients receive timely, appropriate, and efficient care throughout their hospital stay.

Responsibilities include:

• Developing staff and systems for a comprehensive Case Management program.
• Providing leadership and supervision to case managers, social workers, coordinators, and utilization reviewers.
• Assessing needs, planning, and designing services aligned with the hospital mission and patient/family needs.
• Integrating and coordinating services using continuous quality improvement tools.

The ideal candidate is a forward‑thinking professional who thrives in a collaborative, fast‑paced healthcare setting and is passionate about driving positive patient outcomes and reducing readmissions.

• CA Registered Nurse.
• Bachelor’s of Science in Nursing.
• Grandfathered RN prior to April 1, 2015.
• Minimum 5 years’ postgraduate experience as a Licensed Clinical Social Worker from an accredited school of Social Work.
• Minimum 5 years’ experience in a Case Management position.
• Analytical ability for problem identification, assessment, and evaluation of data and statistics from an ongoing review process.
• Proficiency in basic to intermediate computer skills.
• Current BCLS certificate preferred.
• Knowledge of Milliman Criteria and Inter Qual Criteria preferred.

Competitive compensation and benefits: estimated wages, benefits, and other compensation range from $ to $ annually. Exact starting compensation will be determined at hiring based on skill set, years of experience, education, credentials, and licensure.

Full Time

Days

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