Director of Case Management / Utilization Management / CDI

Director of Case Management / Utilization Management / CDI

Location: near Gratiot, OH

Now 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.

Compensation & Benefits

• Pay: $62.50/hr–$75/hr ($130K–$156K annually ) based on experience
• Benefits: Full medical, dental, vision, retirement, PTO
• Stable organization with a long history of community investment

What You Will Do

• 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.

What We’re Looking For

• Master’s degree required (Nursing, Healthcare Administration, Business, or related field)
• Current RN license (Ohio or multistate compact)
• Certified Case Manager (CCM) required
• 3+ years of leadership experience in Case Management, UM, or related functions
• Deep knowledge of:
• Prospective payment systems
• Managed care
• Utilization review
• Discharge planning
• 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

About the Organization

• Forbes Top 100 Hospital
• 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.

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• Master's (Preferred)

Experience:

• Director of Case Management : 5 years (Required)

License/Certification:

• Certified Case Manager (Required)

Work Location: In person