About City of Hope

City of Hope is an independent biomedical research and treatment organization for cancer, diabetes and other life-threatening diseases.

Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin, monoclonal antibodies and numerous breakthrough cancer drugs are based on technology developed at the institution.  AccessHope™, a subsidiary launched in 2019 serves employers and their health care partners by providing access to City of Hope’s specialized cancer expertise.

A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is ranked among the nation’s “Best Hospitals” in cancer by U.S. News & World Report and received Magnet Recognition from the American Nurses Credentialing Center. Its main campus is located near Los Angeles, with additional locations throughout Southern California and in Arizona.

City of Hope’s commitment to Diversity, Equity and Inclusion

We believe diversity, equity and inclusion is key in serving our mission to provide compassionate patient care, drive innovative discovery, and advance vital education focused on eliminating cancer and diabetes in all of our communities.  Our commitment to Diversity, Equity and Inclusion ensures we bring the full range of skills, perspectives, cultural backgrounds and experiences to our work -- and that our teams align with the people we serve in order to build trust and understanding.  We are dedicated to fostering a community that embraces diversity - in ideas, backgrounds and perspectives; this is reflected in our work and represented in our people.

Position Summary

Works under the leadership and supervision of the CNO/SVP Patient Services.  Designs and implements programs and systems to facilitate transitions of care that meet the department and divisional objectives consistent with City of Hope’s philosophy, mission, vision and strategic plan.  Directs and supervises the Case Management department.  Is accountable for managing service, quality and financial goals for the Case Management operations.

Key Responsibilities include:

This position has the degree of independence required to achieve operating results consistent with approved operating plans, objectives, and policies.   The Executive Director (ED) of Case Management is responsible for the overall operation of the Department, including direct interaction with the Medical Staff, compliance with accreditation, title 22 etc.  This position must have the ability to influence physician, staff and leadership though the use of effective communication and data driven results.  In addition, this position develops and maintains departmental operating budget, annual review and development of case management and utilization plans, is responsible for the hiring and scheduling of staff, annual performance evaluation, coaching, training and providing both verbal and written disciplinary action as required.  Moreover, the ED must be familiar with the collective bargaining unions representing the employees. Leads personnel in the provision of safe, high quality patient care, especially as it relates to discharge planning and transitions of care.  Works closely with physicians and Advanced Practice Providers to do the same.  Responsible for the oversight of authorizations and appropriateness of inpatient admissions, continued stay days, and discharges in a timely manner.  Leads teams to achieve strategic outcomes.  Collaborates with personnel to assure appropriate and safe staffing/scheduling.  Serves as a leader/participant on many hospital committees.

Strategic Program Leadership

• Develop, implement, coordinate, monitor and at least annually evaluate Case Management and Utilization Plans in alignment with enterprise needs and regulatory standards. 
• Develop and monitor program budgets for Case Management
• Develop and maintain partnerships with post-acute care partners to ensure that transitions of care can be accomplished in ways that protect our patients and provide the level of care necessary
• Facilitate the ongoing efforts to reduce Length of Stay wherever it is reasonable and safe to do so
• Provide oversight for the safe transition of care for every patient
• Work collaboratively with access, scheduling, revenue cycle and others to ensure methods are in place and functioning to allow for maximized reimbursement and minimized denials and other hazards to payment

Human Resources & Financial Administration

• Attract, retain, coach, mentor and counsel registered nurse case managers, LVN’s, pre-authorization staff and clerical & data analyst team members to coordinate appropriate utilization review, discharge planning and denial management functions.
• Responsible for the department’s daily operations, including achievement of defined goals and objectives through innovative systems and effective departmental policies and procedures.
• Performs annual employee performance evaluation and motivates employees to perform in an efficient and professional manner; recruits and maintain the staff necessary to carry out the functions of the departments.
• Develops revenue growth and effective expense management strategies, inclusive of management of capital and human resources.

Quality & Patient Safety

• Performance Improvement
• Lead team members to achieve high quality services and safe care for patients along the continuum.
• Identify and lead performance improvement activities within Case Management services under the direction of the Chief Nursing Officer
• Develops processes that provides effective communication with physicians, leadership and the staff within the dept.
• Develops and implements programs to ensure timely discharge, standardizing processes whenever possible

Basic education, experience and skills required for consideration:

• Master’s degree in Nursing
• Minimum of 7 years in nursing leadership
• 10 years nursing experience in Case management
• Experience with Discharge Planning/Utilization Management, Denial Management and related regulatory requirements (CMS Conditions of Participation, Joint Commission) experience required.
• Personal computer 80% (Morrisey, EPIC,) pager (10%), phone 10%

Required Certification/Licensure:

• California RN license

Preferred education experience and skills:

• CMSA, ACM or CCM certification preferred

Additional Information:

• As a condition of employment, City of Hope requires staff to comply with all state and federal vaccination mandates.

City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.