Director of Case Management

Job Summary:

We are seeking an experienced Director of Case Management to lead our case management team in ensuring high-quality patient care, efficient resource utilization, and regulatory compliance. The ideal candidate will be a strategic leader with a strong background in case management, utilization review, discharge planning, and patient advocacy within a healthcare setting.

Key Responsibilities:

• Oversee and manage the case management department, ensuring alignment with organizational goals and compliance with healthcare regulations.
• Develop and implement policies and procedures to enhance patient care coordination, discharge planning, and utilization review processes.
• Lead and mentor case managers, social workers, and support staff to optimize patient outcomes.
• Collaborate with physicians, nursing staff, and other healthcare professionals to ensure seamless patient transitions and continuity of care.
• Monitor and analyze case management metrics, identifying opportunities for improvement in efficiency and cost-effectiveness.
• Ensure compliance with federal, state, and local regulations, as well as accreditation standards.
• Manage departmental budgets, staffing, and resource allocation to meet organizational goals.
• Serve as a liaison between patients, families, and healthcare providers to enhance patient satisfaction and experience.

Qualifications:

• Education: Bachelor’s degree in Nursing, Social Work, or a related healthcare field required; Master’s degree preferred.
• Licensure/Certification: Active RN, LCSW, or related healthcare license required. Certified Case Manager (CCM) preferred.
• Experience: Minimum of 5 years of case management experience in a healthcare setting, with at least 2 years in a leadership or management role.
• Strong knowledge of Medicare, Medicaid, and private insurance regulations.
• Experience with utilization review, discharge planning, and care coordination.
• Excellent leadership, communication, and problem-solving skills.