Description

Calling all Esteemed Leaders! Are you a caremanagement leader who thrives in complex acutecare environments and brings strong expertise in utilization management, discharge planning, and interdisciplinary collaboration? Do you excel at leading teams, improving patient flow, and driving quality and costeffective outcomes across the continuum of care? If so, this Director, Care Management opportunity may be an excellent fit.

The Role:

The Director, Care Management oversees all caremanagement functions of Queen of the Valley Medical Center and is accountable for daily operations, personnel leadership, fiscal management, and continuous improvement across the Case Management and Social Services departments.

This role provides strategic direction and operational leadership for caremanagement processes including resource utilization review, care management across the continuum, denial management, discharge planning, and lengthofstay (LOS) management, as outlined in the Medical Center Utilization Plan. The Director collaborates closely with physicians, executive leadership, and interdisciplinary teams to review, analyze, and recommend bestpractice changes that advance Queen of the Valley Medical Centers strategic goals.

All responsibilities are carried out in accordance with Joint Commission standards, state and federal regulatory requirements, and professional practice standards, with minimal supervision.

What You'll Do:

Care Management & Utilization Leadership

• Provide strategic vision and leadership for Case Management and Social Services, including utilization review, discharge planning, case management, clinical documentation management, social services, regulatory compliance, performance improvement, and medicalstaff relations.



• Direct and integrate prospective, concurrent, and retrospective utilization management across the patient hospitalization.



• Collaborate with Community Outreach and Care Network programs to maintain continuity of care across the continuum.

Operational Excellence & Performance Improvement

• Lead departmentspecific and hospitalwide performanceimprovement initiatives focused on LOS optimization, utilization, documentation compliance, and patient outcomes.



• Assess and resolve complex clinical and dischargeplanning issues in collaboration with patients, families, physicians, staff, and community partners.



• Participate in multidisciplinary rounds and care conferences to remove barriers and improve patient flow.

People Leadership & Workforce Management

• Oversee recruitment, staffing, orientation, education, and ongoing professional development of Case Management and Social Work staff.



• Manage staffing and scheduling, performance evaluations, and humanresources matters including progressive discipline when required.



• Create a collaborative, missionaligned work environment that supports Sacred Encounters, engagement, recruitment, and retention.

Physician, Community & Stakeholder Collaboration

• Promote interdisciplinary collaboration with physicians, community partners, and internal stakeholders to optimize care coordination.



• Maintain and strengthen longterm relationships with postacute providers, including longterm care facilities, hospitals, hospices, behavioral health agencies, and community organizations.



• Educate medical staff and caregivers on caremanagement philosophy, best practices, and resource utilization principles.

Financial Stewardship & Resource Management

• Demonstrate accountability for department budgets, productivity targets, and fiscal performance.



• Advocate for resources and technology required to support caremanagement objectives.



• Develop, monitor, and justify operational and capital budget requests.

Governance, Reporting & Committees

• Prepare and present reports, analyses, and materials related to Case Management and Social Services.



• Cochair and/or facilitate the Medical Staff Utilization Management Committee, ensuring timely fiscal, utilization, and quality reporting.



• Serve on hospital and external committees as assigned.



• Support and promote community education initiatives and outreach activities.

Professional Accountability & Development

• Participate in selfappraisal, peer review, and performancereview processes.



• Evaluate and implement performanceimprovement initiatives that support perfect care across patientcare programs.



• Maintain professional competence and pursue continued growth and development.

What You'll Bring:

Education & Credentials

• Bachelors Degree in Nursing or Health Services Administration



• Masters Degree in Nursing, Social Work, or Health Services Administration (preferred) .



• Association of Case Management certification (preferred upon hire) .



• Licensed Clinical Social Worker (LCSW) OR Licensed Registered Nurse (RN) required upon hire.

Leadership & Experience

• 5+ years of Case Management experience in an acutecare setting.



• 3+ years of leadership experience in an acutecare environment.



• Advanced knowledge of caremanagement, utilization review, and dischargeplanning practices.

Professional & Leadership Capabilities

• Strong interpersonal, verbal, and written communication skills to:



• Resolve conflict



• Facilitate collaboration and team building



• Mentor staff for high performance



• Translate complex concepts across varied audiences



• Ability to function effectively in unpredictable, highacuity, and crisis situations.



• Proactive problemsolver who addresses systemlevel outcome issues.



• Proficiency with Microsoft Office tools, databases, spreadsheets, and reporting systems.



• Knowledge of regulatory requirements and organizational development principles.



• Flexibility and adaptability in a healthcare organization undergoing change.

Why Join Us?

• Lead care coordination at scale: Shape utilization, discharge planning, and patient flow across the Medical Center.



• Improve outcomes and efficiency: Drive measurable improvements in LOS, quality, and regulatory readiness.



• Partner with physicians: Strengthen interdisciplinary collaboration and care delivery.



• Build highperforming teams: Develop and retain exceptional caremanagement professionals.



• Serve a mission that matters: Support highquality, patientcentered care across the continuum.

Ready to Shape the Future of Healthcare?

If you are a collaborative, operationally strong leader ready to advance care coordination and utilization excellence, we encourage you to explore this opportunity.

The full pay range is listed in accordance with applicable law. Final compensation will be determined based on qualifications, experience, organizational compensation alignment, and the approved hiring department budget for the position. This position may also be eligible for incentive compensation and benefits.

About Providence

At Providence, our strength lies in Our Promise of Know me, care for me, ease my way. Working at our family of organizations means that regardless of your role, well walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

The Sisters of Providence and Sisters of St. Joseph of Orange have deep roots in California, bringing health care and education to communities from the redwood forests to the beach shores of Orange county - and everywhere in between. In Northern California, Providence provides health care services to Eureka, Fortuna, Healdsburg, Napa, Petaluma and Santa Rosa.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 426703

Company: Providence Jobs

Job Category: Care Management

Job Function: Clinical Care

Job Schedule: Full time

Job Shift: Day

Career Track: Leadership

Department: 7810 UTILIZATION REVIEW

Address: CA Napa 1000 Trancas St

Work Location: Queen of the Valley Medical Center

Workplace Type: On-site

Pay Range: $83.21 - $131.38

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.