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Director of Case Management​/Utilization Management​/CDI

Job in Lexington, Fayette County, Kentucky, 40598, USA
Listing for: Medical Search Associates
Contract position
Listed on 2026-02-12
Job specializations:
  • Healthcare
    Healthcare Management, Healthcare Administration
Salary/Wage Range or Industry Benchmark: 130000 - 156000 USD Yearly USD 130000.00 156000.00 YEAR
Job Description & How to Apply Below
Position: Director of Case Management / Utilization Management / CDI

Director of Case Management / Utilization Management / CDI

Location near Gratiot, OH

Now is your chance to join a Forbes Top 100 Hospital committed to high-quality care, strong leadership, and a collaborative clinical environment. This community-focused hospital sits in a beautiful rural setting, close enough to Columbus to enjoy big-city amenities while working in a supportive, mission-driven organization.

If you're an experienced Case Management leader looking for your next step, this opportunity is worth exploring.

Position Highlights
  • Full-time, Director-level leadership role overseeing Case Management, Utilization Management, and Clinical Documentation Integrity (CDI).
  • Lead a team of 50–60 Case Managers, UM staff, and CDI specialists
    .
  • Work with a respected, supportive leader; role is open due to retirement.
  • Hospital uses Epic EMR and maintains a strong culture of technology, quality, and collaboration.
  • Pay: $62.50/hr–$75/hr ($130K–$156K annually
    ) based on experience.
  • Stable organization with a long history of community investment.
What You Will Do
  • Provide strategic and operational leadership for Case Management, Utilization Review, and CDI across inpatient and emergency services.
  • Ensure effective discharge planning, care coordination, and right-site-of-care decisions.
  • Oversee utilization management, quality assurance, throughput, denial management, and compliance functions.
  • Collaborate closely with Revenue Cycle, Coding, CDI, Physicians, and Managed Care to optimize documentation accuracy, reimbursement integrity, and care transitions.
  • Lead the Physician Advisor Program
    , including performance analysis and committee participation.
  • Use data to drive performance improvement, staffing, workflow optimization, and quality initiatives.
  • Prepare required reports for hospital leadership, committees, regulatory agencies, and payer contracts.
  • Maintain compliance with CMS, QIO, and hospital accreditation standards.
  • Mentor and develop staff; support ongoing education and professional growth.
  • Participate in value-based care initiatives and organizational population health strategies.
What We’re Looking For
  • Master’s degree required (Nursing, Healthcare Administration, Business, or related field)
  • Current RN license (Ohio or multistate compact)
  • 3+ years of leadership experience in Case Management, UM, or related functions
  • Deep knowledge of:
    • Prospective payment systems
    • Managed care
    • CDI and mid-revenue cycle
    • Payor relations and physician advisor programs
  • Strong data analysis skills; able to leverage reporting tools and EMR systems
  • Excellent leadership, communication, organization, and collaboration abilities
About the Organization
  • Strong financial stability and investment in technology (Epic EMR)
  • Highly respected leadership team
  • Mission-driven culture focused on quality care, efficiency, and the patient experience

If you're a forward-thinking Case Management leader ready to make an impact,
apply today and take the next step in your career at one of Ohio’s top healthcare organizations.

Benefits
  • 401(k)
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance
Education
  • Master's (Preferred)
Experience
  • Director of Case Management: 5 years (Required)
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