DIRECTOR OF CASE MANAGEMENT (RN)
Location: Fully Onsite | M-F, Day Hours
SALARY $150-200k based on experience
ROLE OVERVIEW The Director of Case Management provides strategic leadership and oversight for care coordination services across inpatient medical programs, ensuring alignment with organizational priorities, regulatory requirements, and best practices. This role is responsible for the design, implementation, and optimization of care coordination models to enhance patient outcomes, throughput, and resource utilization. The Director partners with interdisciplinary and executive leadership to drive quality improvement, operational excellence, and program growth, while maintaining a limited caseload to stay closely connected to clinical practice.
KEY REQUIREMENTS
- Active RN License
- Case management or care management leadership experience
- Pediatric experience or pediatric complex care experience (preferred)
- Experience with program development or quality improvement (preferred)
KEY RESPONSIBILITIES
Leadership and Operations
- Provides strategic leadership for care coordination services, aligning departmental goals with organizational priorities
- Designs and standardizes care coordination workflows to improve patient flow and transitions of care
- Accountable for key performance metrics including length of stay, readmissions, and utilization management outcomes
- Oversees staffing models, resource allocation, and financial oversight including budget development and forecasting
- Ensures compliance with regulatory requirements and accreditation standards
Quality and Performance
- Leads quality improvement and performance initiatives using data to drive measurable outcomes
- Leads program development and expansion efforts, identifying opportunities for innovation and growth
- Represents care coordination in organizational committees and strategic initiatives
Team Development
- Builds and sustains a high-performing team through mentorship, leadership development, and performance management
- Partners with nursing, physician, and administrative leadership to enhance interdisciplinary collaboration
Clinical Practice
- Maintains a limited caseload prioritizing patients with complex medical, social, or system-level needs
- Provides direct involvement in high-risk and escalation cases including payer challenges and discharge planning obstacles
- Utilizes frontline clinical experience to inform workflow design and policy development
Utilization Review
- Oversees utilization management processes to ensure timely and compliant submission of clinical information
- Collaborates with medical and financial teams to reduce denials and optimize reimbursement
- Monitors trends and identifies opportunities for system-level improvement
REQUIREMENTS
- RN License (Required)
- Minimum of 5-10 years of progressive nursing experience, including significant leadership experience in care coordination, case management, or related areas
BENEFITS 401(k) with matching, health, dental, and vision insurance, paid time off, tuition reimbursement
How to apply.
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