Resource Director of Case Management Full Time

At ScionHealth, we empower our caregivers to do what they do best — provide compassionate, high-quality patient care. We are committed to fostering a culture of service excellence, teamwork, and continuous improvement. Our employees are supported, valued, and given opportunities to grow while making a meaningful impact in the communities we serve.

Job Summary

The Resource Director of Case Management provides interim leadership and operational oversight of hospital case management and utilization review services at assigned facilities. Reporting to the Regional Senior Director of Case Management, this role is responsible for planning, coordinating, and evaluating all case management activities to ensure optimal patient outcomes, effective resource utilization, and financial reimbursement.

The Resource Director collaborates with hospital leadership, payors, referral sources, and interdisciplinary teams to support high-quality care and timely discharge planning while promoting compliance with organizational policies and regulatory standards.

Essential Functions

• Provide interim leadership for case management and utilization review departments at assigned facilities.
• Oversee care coordination, discharge planning, and interdisciplinary collaboration to ensure quality and efficiency.
• Direct management of patient financial resources through coordinated service delivery and payor requirements.
• Establish effective relationships with payors and referral sources to facilitate timely admissions and discharges.
• Serve as a resource and advocate for patients and families throughout the continuum of care.
• Collaborate with Quality Management, Infection Control, and other hospital departments to align care goals and regulatory compliance.
• Partner closely with the hospital CEO/Administrator, CFO, CCO, and Regional Office to support operational goals.
• Evaluate and improve case management workflows and staffing performance.
• Ensure documentation accuracy, regulatory adherence, and timely reporting of utilization data.
• Participate in quality improvement initiatives and readiness for accreditation or audits.

Knowledge, Skills, and Abilities

• Strong knowledge of case management principles, utilization review, and discharge planning.
• Understanding of healthcare reimbursement models and payor processes.
• Excellent leadership, organizational, and problem-solving skills.
• Ability to build effective working relationships with diverse clinical and administrative teams.
• Strong verbal and written communication skills.
• Proficiency with electronic medical records (EMR) and case management systems.
• Flexibility to travel and serve in temporary assignments across multiple locations.

Education

• Bachelor’s Degree in a clinical field. (Required)
• Bachelor’s Degree in Nursing (BSN). (Preferred)
• Equivalent combination of education and experience. (May be considered)

Licenses/Certifications

• Registered Nurse (RN) – State and/or Compact Licensure or Respiratory Therapist, Physical Therapist, Occupational Therapist, or Social Worker (LSW or LCSW). (Required upon hire)
• Certified Case Manager (CCM), Accredited Case Manager (ACM), or Certified Rehabilitation Registered Nurse (CRRN). (Preferred upon hire)

Experience

• Three (3) or more years of hospital case management experience. (Required)
• Prior experience in a leadership or interim director role. (Preferred)
• Experience demonstrating familiarity with managed care, reimbursement, and regulatory standards. (Required)