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Director of Case Management
Position Summary:
As the Director of Case Management, you will have the opportunity to provide strategic leadership and oversight of case management operations across Nobis Rehabilitation Partners hospitals, ensuring high standards of care coordination, discharge planning, utilization review, and payer performance across all locations. You will play a key role in advancing patient progression, strengthening reimbursement outcomes, supporting hospital operations, and driving case management excellence. As the Director of Case Management, you will mentor and support hospital case management leaders and teams while promoting best practices across all hospitals.
Responsibilities:
- Implements the strategic plan and priorities for hospital case management leaders to ensure efficient and effective case management operations that support patient centered care across all hospitals.
- Oversees and leads the implementation of strategic plans, clinical objectives, policies, standards, procedures, and best practices that support excellence in case management services at Nobis Rehabilitation Partners.
- Guides and leads organization wide case management initiatives that drive continuous improvement, standardization, regulatory compliance, and strong discharge outcomes.
- Monitors and takes action to improve performance related to discharge planning, length of stay management, avoidable delays, discharge to community, and patient satisfaction.
- Leads and champions interdisciplinary collaboration between nursing, therapy, physicians, and case management to support safe and timely transitions of care.
- Provides oversight of Interdisciplinary Team (IDT) meetings, ensuring hospitals maintain compliant processes for scheduling, facilitation, documentation, patient progression planning, and regulatory expectations.
- Supports hospital teams in strengthening IDT meeting effectiveness, accountability, discharge barrier resolution, and communication across disciplines.
- Develops and maintains collaborative working relationships with senior operational leaders, payers, physicians, referral partners, and stakeholders to advance hospital goals and objectives.
- Ensures case management services remain compliant with all applicable regulatory, licensing, accreditation, and payer requirements.
- Provides system oversight of survey readiness for case management related standards and supports action planning following regulatory or accreditation reviews.
- Responsible for mentoring, onboarding, and development programs for hospital case management leaders and staff.
- Leads succession planning to ensure leadership continuity and accountability across case management departments.
- Proactively initiates gap analysis and needs assessments to identify opportunities for leadership development, workflow improvement, and case management practice advancement.
- Sponsors and champions key case management initiatives, programs, and task forces to improve patient care across Nobis Rehabilitation Partners.
- Provides oversight of staffing models, productivity expectations, labor performance, and team structure for case management departments.
- Supports startup hospitals, acquisitions, and integration efforts related to case management operations and readiness.
Utilization Review and Revenue Protection:
- Provides oversight of utilization review processes to ensure timely and accurate payer authorizations, continued stay reviews, and medical necessity support.
- Monitors authorization timeliness, denial trends, peer to peer opportunities, appeal outcomes, and avoidable reimbursement risk.
- Partners with hospital leaders, physicians, revenue cycle, and finance teams to resolve barriers impacting payment and patient progression.
- Oversees processes related to concurrent review, payer communication, continued authorization submissions, and denial prevention strategies.
- Develops standardized workflows across hospitals to strengthen payer performance and reduce revenue leakage.
- Reviews trends related to denials, delayed authorizations, avoidable extended stays, and documentation deficiencies impacting reimbursement.
- Leads education for case management leaders and teams regarding payer expectations, authorization strategy, and documentation integrity.
- Uses analytics to identify outliers in length of stay, denial patterns, and authorization performance requiring follow up.
Qualifications:
- Master’s degree Preferred. CCM or ACM
- Registered Nurse licensure required. CRRN preferred.
- 10+ years of progressive clinical leadership experience, including case management or care coordination leadership experience.
- Multi-site oversight experience preferred.
- Inpatient Rehabilitation experience required.
- Strong knowledge of CMS IRF regulations, discharge planning requirements, utilization review, payer authorization processes, IDT meeting requirements, and interdisciplinary rehabilitation models.
- Experience with survey readiness and accreditation standards preferred.
- Role requires up to 75% travel.
- Experience in operational improvement, change management, and performance leadership.
- Strategic thinker with strong decision-making ability.
- Effective communicator with ability to influence leaders and build alignment.
Join our team and you will experience a total rewards package to support your health, life, career and retirement including:
- A supportive and collaborative work environment
- Opportunities to progress in function, skill, and pay
- A competitive wage scale
- A comprehensive health and wellness package including medical, dental, and prescription drug coverage
We offer a benefits package that will best suit your family’s needs. You can choose from a variety of medical coverage plans that best fit your lifestyle. You also have the option to enroll in additional perks such as 401k, life insurance, and disability plans.
NOBIS REHABILITATION PARTNERS LLC is an EEO employer - M/F/Vets/Disabled
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