Job Description
Description Calling All Esteemed Leaders! Are you a collaborative care management leader with a passion for improving patient flow, strengthening care coordination, and advancing outcomes across multiple hospitals? Do you thrive in complex environments where operational alignment, physician partnership, and data‑driven improvement are critical to success? This leadership opportunity invites your expertise. The Role The Director, Care Management provides leadership and oversight of Care Management services across Santa Rosa Memorial Hospital, Petaluma Valley Hospital, and Healdsburg Hospital. This role is responsible for ensuring an integrated approach to utilization management, discharge planning, care coordination, and social services across all three facilities. The Director focuses on improving patient flow, reducing barriers to care, and supporting safe, timely transitions throughout the continuum of care. The Director works closely with hospital leadership, medical staff, and community partners to align workflows, standardize best practices, and maintain regulatory compliance. This position plays a critical role in driving performance, optimizing resource utilization, and supporting consistent, high‑quality patient care across the Sonoma region. What You’ll Do Multi‑Hospital Leadership & Integration Lead and coordinate Care Management operations across SRMH, PVH, and HH, ensuring aligned workflows, consistent standards of practice, and systemwide collaboration. Ensure seamless integration of services across all sites, promoting continuity, reliability, and shared accountability. Performance, Outcomes & Throughput Improvement Monitor, analyze, and improve key performance metrics, including length of stay, avoidable days, readmissions, and discharge efficiency. Implement standardized throughput processes to enhance patient flow across emergency, inpatient, and post‑acute transitions. Interdisciplinary & Physician Collaboration Partner with medical staff and physician advisors to resolve barriers to care and support evidence‑based utilization management. Develop strong relationships with Nursing, Quality, Social Services, and ancillary departments to support cross‑campus coordination. Regulatory, Accreditation & Compliance Ensure compliance with CMS, CDPH, The Joint Commission, EMTALA, payer requirements, and internal system policies. Oversee regulatory readiness activities and ensure consistent documentation standards in utilization review and discharge planning. Operational & Strategic Leadership Evaluate and design staffing models, departmental structures, and resource allocation across all sites. Lead strategic initiatives supporting care transformation, population health priorities, and community integration. Fiscal Stewardship Assume accountability for fiscal management of Care Management services across all entities. Develop, present, and manage annual budgets, including personnel, supplies, and operational resources. Monitor budget performance, analyze variances, and implement corrective actions. Monitor payer trends and lead interventions to reduce avoidable denials and improve medical necessity compliance. Partner with Revenue Cycle, Physician Advisors, and Payer Relations to improve authorization processes and reimbursement integrity. Implement system, technology , and process improvements that enhance efficiency and cost containment. Divisional Alignment & Standardization Align Care Management practices with regional and system‑wide initiatives, ensuring consistency in policies, workflows, and documentation across all hospitals. Workforce Optimization & Talent Development Evaluate staffing needs across sites and ensure equitable resource distribution based on acuity, volume, and throughput demands. Recruit, retain, and develop high‑performing Care Management teams. Promote professional growth and leadership development across managers, supervisors, and front‑line teams. Qualifications Education Bachelor’s Degree in Nursing Master’s Degree in Nursing or related healthcare field (preferred) Certification Active California Registered Nurse License (required upon hire; vendor‑managed) Experience & Expertise Minimum of 5 years of Care Management experience in an acute care setting Minimum of 3 years of progressive