District Manager, Clinical Resource Management

The Manager, Clinical Resource Management (Case Management or Utilization Review) supervises, facilitates, and co-ordinates the Care Management systems and supports the Palomar Health Strategic Plan across the district. This includes all activities of the Case Managers and Social Workers. The position evaluates patient‑care outcomes as well as the financial outcomes that this system impacts.

It collaborates with all hospital departments within Palomar Health, medical staff, Home Health Care/Hospice agencies, durable medical equipment companies, nursing homes, and others to assure patient‑care coordination is efficient, of high quality, and cost‑effective. He/she is responsible for the operational functions of the department, including staffing, scheduling, performance management, and financial/productivity. This position assists in teaching others how to analyse patient‑care data and how to present it to reach organisational goals.

The position is required to work with all financial payers for reimbursement and excellent discharge planning. He/she follows Palomar Health's values and ensures these standards are followed by the department's associates. Actively participates in the development and monitoring of strategic initiatives as defined by the CRM leadership team.

Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position.

Knowledge of standard office equipment (e.g., calculator, fax, photocopier) and personal computer & computer software skills (e.g., MS Windows, Excel, Access, Word, Powerpoint, internet, e‑mail). Windows computer skills including proficient use of keyboarding, mouse, drop‑down menus, scroll bars, opening folders, copying, and similar operations required upon employment or within the first two weeks of employment to perform the essential functions of the job.

Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws, and standards. Carries out the mission, vision, and quality commitment of Palomar Health.

Job Requirements

• Minimum Education: Bachelor's Degree in Nursing or related healthcare field.
• Preferred Education: Master's Degree in a healthcare related field.
• Minimum Experience: 2+ years recent management/leadership experience; 4+ years experience in Acute Hospital Case Management and/or Utilization Review.
• Required Certification: American Heart Association recognised BLS – Healthcare Provider.
• Preferred Certification: Certified Case Manager.
• Required License: Valid Driver's License; Current CA RN License.