MGR CASE MANAGEMENT

JOB DESCRIPTION DETAILS
- Job Summary:
  - The Manager of Case Management provides operational leadership and oversight for the hospital’s case management program, including care coordination, utilization management, discharge planning, and resource management across the continuum of care. This role ensures the effective integration of clinical care management, regulatory compliance, and financial stewardship to support safe, timely patient transitions and optimal utilization of healthcare resources.
    The Manager works collaboratively with physicians, nursing leadership, ancillary departments, and community partners to promote high-quality, cost-effective care delivery while supporting organizational goals related to patient outcomes, patient experience, and population health management.
- Education:
  - Position requires a Bachelor’s degree in nursing, Social Work, or related healthcare field. Master’s degree in Nursing, Healthcare Administration, Social Work, or related field preferred.
- Registration/Certification/Licensure:
  - Active RN (MD State licensure) or Social Work license (as applicable)
- Experience:
  - Minimum 5 years of acute care clinical experience
  - Minimum 2 years of leadership or supervisory experience in case management or care coordination
  - Case management certification (ACM, CCM, or equivalent) preferred
  - Experience with utilization management, payer regulations, and hospital throughput operations
- Other Requirements:
  - Maintains unit-specific and hospital competencies, mandatory learning, and any clinical certifications required in accordance with the Staff Education and Training policy GA-057 and/or any other department requirements.
  - Provides daily operational oversight of the Case Management department, including staffing, scheduling, productivity, and performance management.
  - Proficient in PC software such as Microsoft office, Excel, and PowerPoint.
  - Demonstrates effective verbal and written communication.
  - Ensures compliance with CMS Conditions of Participation, Joint Commission standards, and payer requirements.
  - Promotes a collaborative culture supporting interdisciplinary rounds and proactive discharge planning.
  - Develops and implements departmental policies, procedures, and workflows aligned with regulatory and accreditation standards.
  - CPR required within 30 days of hire.