Director of Clinical Care Coordination

The Director of Clinical Care Coordination 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. The Director maintains a limited, strategically selected caseload to remain closely connected to clinical practice, inform program development, and support complex care coordination needs.

PRINCIPAL DUTIES AND RESPONSIBILITIES

• Provides strategic leadership and direction for clinical care coordination services across inpatient medical programs, aligning departmental goals with organizational priorities
• Designs, implements, and standardizes care coordination workflows to improve patient flow, transitions of care, and overall efficiency across the continuum
• Accountable for achieving key performance metrics, including length of stay (LOS), readmissions, utilization management outcomes, and patient/family experience
• Leads the development, implementation, and evaluation of quality improvement and performance initiatives using data to drive measurable outcomes
• Partners with nursing, physician, and administrative leadership to enhance interdisciplinary collaboration and ensure seamless care delivery
• Oversees staffing models, role optimization, and resource allocation to meet patient and organizational needs
• Responsible for financial oversight, including budget development, forecasting, and monitoring to ensure fiscal accountability
• Build and sustain a high-performing team through mentorship, leadership development, and performance management
• Ensures compliance with regulatory requirements, accreditation standards, and organizational policies
• Leads program development and expansion efforts, identifying opportunities for innovation and growth in care coordination services
• Represents care coordination in organizational committees and strategic initiatives

Clinical Practice Component

• Maintains a limited and highly focused caseload, prioritizing patients with complex medical, social, or system-level needs
• Provides direct involvement in high-risk, high-complexity, or escalation cases, including care coordination barriers, payer challenges, and discharge planning obstacles
• Utilizes frontline clinical experience to inform workflow design, policy development, and performance improvement initiatives
• Supports team members in complex case management through consultation, coaching, and real-time problem-solving, rather than routine case assignments.

UTILIZATION REVIEW RESPONSIBILITIES

• Provides oversight of utilization management processes to ensure timely, accurate, and compliant submission of clinical information
• Collaborates with medical and financial teams to address barriers to coverage, reduce denials, and optimize reimbursement
• Develop strategies to improve utilization efficiency and payer communication
• Monitors trends and outcomes, identifying opportunities for system-level improvement

Required experience: Minimum of 7–10 years of progressive nursing experience, including significant leadership experience in care coordination, case management, or related areas

Preferred experience: Pediatric experience and prior experience in program development, quality improvement, and system-level leadership

Job Type: Full-time

Experience:

• RN Case management: 7 years (Required)

License/Certification:

• RN License (Required)