Corp. VP, Case Management & Utilization

Your job is more than a job

The Corporate Vice President of Case Management and Utilization for LCMC Health:

• Drives transformational leadership across LCMC's Case Management (CM) and Utilization Management (UM) service lines, elevating performance and system‑wide outcomes.
• Champions the mission and vision of CM and UM while forging powerful strategic partnerships that enhance care coordination and create seamless care transitions for patients.
• Oversees and optimizes daily operations, ensuring exceptional execution of care coordination and utilization review through smart, system‑wide resource alignment.
• Builds true systemness by uniting teams around shared best practices, innovative solutions, and proven models that strengthen organizational consistency and quality.
• Designs, implements, and scales advanced CM tools that drive efficiency, improve decision‑making, and support exceptional patient care across the entire organization.
• Inspires and develops CM and UM Directors, guiding them to achieve ambitious strategic goals and advance key initiatives that move the organization forward.

EXPERIENCE QUALIFICATIONS

• 5+ years of experience in case management leadership within a large multi-hospital system.
• 10+ years of overall case management experience

EDUCATION QUALIFICATIONS

• Bachelor's Degree in Nursing required
• Master's Degree in Nursing, Healthcare Administration, or Case Management preferred

LICENSES AND CERTIFICATIONS

• Minimum Required: Registered Nurse
• Preferred: ACM (Accredited Case Manager) through ACMA, CCM (Certified Case Manager) through CCMC; Board certification in Nursing Case Management (RN-BC) through ANCC.

GENERAL DUTIES

• Service Line Operational Leadership
• Provide direct leadership, oversight, and accountability for the operational effectiveness of Case Management and Utilization Management at the facility and corporate level.
• Execute the Case Management and Utilization Management strategic plan.
• Ensure standardization and organizational alignment across LCMC facilities.
• Develop a culture of high performance and continuous improvement that values learning and a commitment to quality.
• Collaborate with facility and corporate leaders to develop strategies to improve outcomes related to length of stay, hospital throughput, and patient experience.
• Operational Improvement & Profitability

Identify opportunities to optimize performance, build internal competencies, and create a rigorous approach to case management with a strong focus on accountability and appropriate use or resources.

• Adjust case management and utilization management strategies based on business needs.
• Manage complex projects, including resource allocation or organizational changes related to optimization or implementation of new initiatives at the facility and corporate level.
• Collaborate with Case Management/Utilization Management leadership and the hospital CFOs to develop and implement measurement tools to track operational and financial performance.
• Use internal and external benchmarks to drive high-quality outcomes and efficient processes.
• Team and Workforce Development
• Communicate effectively with a diverse range of stakeholders, including clinicians, administrators, and front-line staff. Build strong relationships and provide direction to Case Management/Utilization Management Directors to ensure standardization and consistency across all facilities.
• Collaborate with the Case Management/Utilization Management leaders and CFOs to ensure appropriate skill mix and staffing ratios for social workers, case managers, and utilization managers.
• Attract, develop, and retain talent throughout LCMC to ensure a succession plan.
• Consistently assess the learning and development needs of Case Management/Utilization Management. Provide education as needed based on findings.
• Regulatory Compliance
• Understand regulatory compliance requirements - state and federal regulations.
• Accountability for regulatory compliance with discharge planning and utilization review Conditions of Participation.
• Accountability for third party payor requirements related to utilization review practices.
• Develop and implement service line policies and operational standards in accordance with the state and federal regulations. Reassess and update as needed.
• Ensure compliance with internal policies and operational standards.

SKILLS AND ABILITIES

• Strong direct clinical experience and clinical acumen.
• Knowledge and experience in utilization review and management.
• Complex decision-making skills.
• Strong interpersonal communication skills.
• Ability to interact within a health system as well as external vendors.
• Demonstrated leadership ability.
• Influential and supportive of others. Works well with interdisciplinary team members.
• Strong analytic skills.
• Ability to present material effectively.
• Experience in developing and leading governance models for case management and utilization management.
• Communicate effectively in a matrix environment.

WORK SHIFT:

Days (United States of America)

LCMC Health is a community.

Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little "come on in" attitude is the foundation of LCMC Health's culture of everyday extraordinary

Your extras

• Deliver healthcare with heart.
• Give people a reason to smile.
• Put a little love in your work.
• Be honest and real, but with compassion.
• Bring some lagniappe into everything you do.
• Forget one-size-fits-all, think one-of-a-kind care.
• See opportunities, not problems - it's all about perspective.
• Cheerlead ideas, differences, and each other.
• Love what makes you, you - because we do

You are welcome here.

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

Simple things make the difference.

1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information.

2. To ensure quality care and service, we may use information on your application to verify your previous employment and background.

3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed.

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