Director of Case Management
Wheeler Staffing Partners, Palm Springs, CA, United States
Position Overview
Wheeler Staffing Partners is seeking an experienced
Director of Case Management
to lead hospital-based case management operations in Palm Springs, California. This leadership role is responsible for overseeing
utilization management, transition management, and operational performance of the Case Management Department
to ensure effective use of hospital resources, optimized patient throughput, regulatory compliance, and strong revenue cycle outcomes.
The Director of Case Management will lead initiatives that support
medical necessity compliance, denial prevention, length-of-stay management, readmission reduction, and safe patient transitions across the continuum of care . This role collaborates closely with physicians, executive leadership, clinical teams, and post-acute providers to ensure efficient care coordination and compliance with state and federal regulations.
The ideal candidate brings
hospital-based case management experience, strong operational leadership skills, and a deep understanding of healthcare regulatory and utilization management standards .
Key Responsibilities
Provide strategic oversight and operational leadership for the hospital’s Case Management Department.
Lead utilization management, transition management, and care coordination functions to ensure effective patient flow and resource utilization.
Ensure alignment with national case management standards and best practices.
Promote patient-centered care coordination while supporting appropriate levels of care and sequencing of services.
Oversee the hospital’s Utilization Management program to ensure medical necessity compliance and denial prevention.
Monitor utilization data and implement performance improvement initiatives to optimize hospital utilization and throughput.
Ensure documentation and revenue cycle processes meet payer requirements and regulatory standards.
Develop strategies to prevent payer disputes and minimize reimbursement delays.
Patient Throughput & Transition Management
Implement processes to support efficient patient throughput and timely discharge planning.
Lead initiatives focused on reducing readmissions, improving patient satisfaction, and promoting safe transitions of care.
Collaborate with interdisciplinary teams to coordinate post-acute care planning and transitions.
Regulatory Compliance & Accreditation
Ensure compliance with federal and state regulations related to case management services.
Maintain adherence to accreditation standards and regulatory guidelines governing hospital case management operations.
Support audit readiness and ensure compliance with all applicable regulatory and policy requirements.
Provide education and feedback to physicians regarding hospital utilization patterns, medical necessity requirements, and documentation standards.
Partner with medical staff leadership to promote efficient care delivery and regulatory compliance.
Operational Leadership
Manage department operations to ensure effective patient throughput and reimbursement outcomes.
Participate in oversight of post-acute provider network relationships and care coordination processes.
Lead team development, operational improvements, and department performance initiatives.
Perform additional duties as assigned in support of hospital operations.
Qualifications Education Candidates must meet one of the following educational pathways based on licensure:
For Registered Nurse (RN) candidates
Bachelor’s Degree in Nursing (BSN), Business Administration, or Healthcare Administration required.
For Social Work candidates
Master’s Degree in Social Work (MSW) required.
Preferred Education Advanced graduate education preferred but not required:
Master of Science in Nursing (MSN)
Master of Business Administration (MBA)
Master of Social Work (MSW)
Master of Healthcare Administration (MHA)
Experience Required
Minimum
3 years of experience
in one of the following areas:
Acute hospital case management
Healthcare leadership experience within a hospital setting
Experience must be
hospital-based (acute care) . Experience exclusively in SNF, home health, LTAC, or post-acute settings does not meet the requirement.
Preferred
5+ years of case management leadership experience
in an acute care hospital environment
Experience supporting
multiple hospital locations or multi-site healthcare systems
Licensure & Certifications Required Candidates must hold one of the following active licenses:
Registered Nurse (RN)
Licensed Clinical Social Worker (LCSW)
Licensed Master Social Worker (LMSW)
Additional requirements:
License must be active and in good standing.
License must be valid in the state of practice and comply with all regulatory requirements.
Relocation candidates must be eligible to obtain the required license in the state of California.
Preferred
Accredited Case Manager (ACM) certification issued by the American Case Management Association (ACMA)
Why Work with Wheeler Staffing Partners At Wheeler Staffing Partners, we go beyond traditional recruiting by building long-term career partnerships with the professionals we serve. Our team provides personalized support throughout the hiring process, including resume guidance, interview preparation, offer negotiation, and onboarding assistance. We are committed to connecting exceptional talent with organizations where they can lead, grow, and make meaningful impact in their field. When you partner with Wheeler Staffing Partners, you gain a dedicated advocate focused on your long-term success.
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Director of Case Management
to lead hospital-based case management operations in Palm Springs, California. This leadership role is responsible for overseeing
utilization management, transition management, and operational performance of the Case Management Department
to ensure effective use of hospital resources, optimized patient throughput, regulatory compliance, and strong revenue cycle outcomes.
The Director of Case Management will lead initiatives that support
medical necessity compliance, denial prevention, length-of-stay management, readmission reduction, and safe patient transitions across the continuum of care . This role collaborates closely with physicians, executive leadership, clinical teams, and post-acute providers to ensure efficient care coordination and compliance with state and federal regulations.
The ideal candidate brings
hospital-based case management experience, strong operational leadership skills, and a deep understanding of healthcare regulatory and utilization management standards .
Key Responsibilities
Provide strategic oversight and operational leadership for the hospital’s Case Management Department.
Lead utilization management, transition management, and care coordination functions to ensure effective patient flow and resource utilization.
Ensure alignment with national case management standards and best practices.
Promote patient-centered care coordination while supporting appropriate levels of care and sequencing of services.
Oversee the hospital’s Utilization Management program to ensure medical necessity compliance and denial prevention.
Monitor utilization data and implement performance improvement initiatives to optimize hospital utilization and throughput.
Ensure documentation and revenue cycle processes meet payer requirements and regulatory standards.
Develop strategies to prevent payer disputes and minimize reimbursement delays.
Patient Throughput & Transition Management
Implement processes to support efficient patient throughput and timely discharge planning.
Lead initiatives focused on reducing readmissions, improving patient satisfaction, and promoting safe transitions of care.
Collaborate with interdisciplinary teams to coordinate post-acute care planning and transitions.
Regulatory Compliance & Accreditation
Ensure compliance with federal and state regulations related to case management services.
Maintain adherence to accreditation standards and regulatory guidelines governing hospital case management operations.
Support audit readiness and ensure compliance with all applicable regulatory and policy requirements.
Provide education and feedback to physicians regarding hospital utilization patterns, medical necessity requirements, and documentation standards.
Partner with medical staff leadership to promote efficient care delivery and regulatory compliance.
Operational Leadership
Manage department operations to ensure effective patient throughput and reimbursement outcomes.
Participate in oversight of post-acute provider network relationships and care coordination processes.
Lead team development, operational improvements, and department performance initiatives.
Perform additional duties as assigned in support of hospital operations.
Qualifications Education Candidates must meet one of the following educational pathways based on licensure:
For Registered Nurse (RN) candidates
Bachelor’s Degree in Nursing (BSN), Business Administration, or Healthcare Administration required.
For Social Work candidates
Master’s Degree in Social Work (MSW) required.
Preferred Education Advanced graduate education preferred but not required:
Master of Science in Nursing (MSN)
Master of Business Administration (MBA)
Master of Social Work (MSW)
Master of Healthcare Administration (MHA)
Experience Required
Minimum
3 years of experience
in one of the following areas:
Acute hospital case management
Healthcare leadership experience within a hospital setting
Experience must be
hospital-based (acute care) . Experience exclusively in SNF, home health, LTAC, or post-acute settings does not meet the requirement.
Preferred
5+ years of case management leadership experience
in an acute care hospital environment
Experience supporting
multiple hospital locations or multi-site healthcare systems
Licensure & Certifications Required Candidates must hold one of the following active licenses:
Registered Nurse (RN)
Licensed Clinical Social Worker (LCSW)
Licensed Master Social Worker (LMSW)
Additional requirements:
License must be active and in good standing.
License must be valid in the state of practice and comply with all regulatory requirements.
Relocation candidates must be eligible to obtain the required license in the state of California.
Preferred
Accredited Case Manager (ACM) certification issued by the American Case Management Association (ACMA)
Why Work with Wheeler Staffing Partners At Wheeler Staffing Partners, we go beyond traditional recruiting by building long-term career partnerships with the professionals we serve. Our team provides personalized support throughout the hiring process, including resume guidance, interview preparation, offer negotiation, and onboarding assistance. We are committed to connecting exceptional talent with organizations where they can lead, grow, and make meaningful impact in their field. When you partner with Wheeler Staffing Partners, you gain a dedicated advocate focused on your long-term success.
#J-18808-Ljbffr