More jobs:
Director of Case Management/Utilization Management/CDI
Job in
Lexington, Fayette County, Kentucky, 40598, USA
Listed on 2026-02-12
Listing for:
Medical Search Associates
Contract
position Listed on 2026-02-12
Job specializations:
-
Healthcare
Healthcare Management, Healthcare Administration
Job Description & How to Apply Below
Director of Case Management / Utilization Management / CDI
Location near Gratiot, OHNow 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.
- 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.
- 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
- 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.
- 401(k)
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Master's (Preferred)
- Director of Case Management: 5 years (Required)
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