VP of Case Management

October 18, 2020
Los Angeles, CA
Job Type


The Vice President, Case Management is responsible for setting the strategy for Case Management for the California Region.  Leads the development and oversees the development and execution of policies and procedures, practices workflow, and data reporting for the California Region. Directing the standardization of CM policies, practices workflow and data reporting within the system. Maintains quality patient care and adheres to all relevant compliance activities. Develops trust, cooperation, and collaboration with administrative, medical staff and departments across the California Region.

Job Responsibilities/Duties

  • • Oversees and ensures that day to day Case Management operations of the California Region are completed in an efficient manner and in accordance with organizational policies and values.  Demonstrates problem-solving, critical thinking, and prioritization of work and resolves issues as they arise in an appropriate and timely manner. Develops and executes on short- and long-term goals for the department consistent with established hospital/organization goals and objectives.
  • • Coordinates the education and training of all case management staff across the Southern California region.  Plans and ensures completeness and appropriateness of training material.  Procures and deploys educational resources to offer continual support to hospital staff on MCG and Allscripts proficiencies.   Ensures MCG IRR proficiency level of 95% or better for all case managers, including directors and managers.
  • • Coordinates regional staffing efforts across the region utilizing IHR incentives.  Leads this effort on a day-to-day basis by accessing each facilities’ schedules and real-time information on unexpected staffing gaps such as call offs.   Communicates to all case managers (and directors) asking for their assistance to fill these staffing gaps across the region.  Ensures all qualifying IHR incentives are properly coded and paid. 
  • • Contributes at the most senior level by working across strategic and business units to set, engage and achieve objectives of the organization.  Demonstrates the ability to critically evaluate and provide input to areas outside own area of expertise.  Acts as a coach and positive role model for staff by establishing and maintaining a safe work environment that fosters positive morale.  Provides guidance and support to director/manager/supervisor/staff as needed.


Minimum Education: High School Diploma. Bachelors or Masters of Science in Nursing preferred.

Minimum Experience: Ten (10) years of experience in an Acute Care Case Management/Utilization Review role, with at least three (3) years in a director level role. Knowledge of standard utilization screening tools such as MCG and InterQual. Experience with Case Management EMR Systems such as, Midas, Cerner and/or Allscripts Care Manager. Knowledge of DRG, Value Based, Risk Based and Per Diem payment methodologies. Knowledge of all Federal, State and Local regulatory standards. Computer literacy and proficiency. Professional demeanor with Healthcare team. Strong Organizational and Time Management skills with ability to effectively prioritize tasks.

Req. Certification/Licensure: Current Licensure as a Registered Nurse in the State of California. Certified Case Manager (CCM) or other Case Management/Nursing Certification preferred. Lean Six Sigma Certification preferred.

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