Area Manager, Case Management

MML US•San Diego, CA

1d•Remote

About The Position

Mainstay Medical is a medical device company focused on marketing an innovative implantable neurostimulation system, ReActiv8®, for people with disabling chronic mechanical Low Back Pain. The company is headquartered in Dublin, Ireland, with subsidiaries operating in the United States, Australia, the United Kingdom, and Germany. The Area Manager, Case Management is a player-coach leader who develops a team of Case Managers while maintaining an active patient portfolio. The role is accountable for team performance, patient progression, and service excellence, ensuring a consistent patient journey from identification through implant. The Manager partners with Patient Access, Market Access, Clinical, Sales, and Operations, and serves as the primary escalation point for complex patient situations, all while balancing direct patient work with people leadership in a growing organization.

Requirements

Bachelor’s degree in nursing, healthcare, business, or a related field, or equivalent healthcare experience.
5+ years in case management, care coordination, patient access, reimbursement, or healthcare operations.
Experience managing complex patient journeys.
Strong knowledge of benefits verification, prior authorization, appeals, and reimbursement.
Strong analytical, problem-solving, communication, and coaching skills.
Proven ability to balance patient responsibilities with people leadership, prioritize competing demands, and lead teams through change.

Nice To Haves

2+ years of leadership, team lead, or people management experience preferred.
Experience with Salesforce or similar cloud-based systems preferred.

Responsibilities

Manage, coach, and develop a team of Case Managers, including hiring, onboarding, performance reviews, and development planning.
Set performance and patient experience standards; monitor workload, capacity, and resource allocation.
Foster a culture of accountability, collaboration, and continuous improvement.
Serve as primary escalation point for complex patient, provider, field, and operational issues.
Maintain an active patient portfolio and coordinate with patients, providers, field sales, and internal stakeholders from identification through implant.
Lead complex cases and maintain visibility into high-priority, stalled, or at-risk patients.
Model best practices in patient engagement, communication, documentation, and case progression.
Drive patient progression across all phases of treatment; establish and monitor KPIs (progression, conversion, engagement, timeliness, barriers to care).
Work with Case Managers to identify stalled patients, set clear ownership and next steps, and reduce patient leakage.
Use data to identify trends, gaps, and improvement opportunities.
Review patient interactions and documentation for quality, consistency, and compliance.
Provide actionable feedback; ensure accurate, timely documentation in Salesforce and adherence to SOPs and privacy requirements.
Standardize best practices across the team.
Partner with the Manager, Patient Access Operations for seamless handoffs and accountability.
Collaborate with Market Access, Reimbursement, Sales Operations, Clinical Affairs, and Field Sales to resolve access barriers and support territory planning and patient prioritization.
Build strong relationships with physician offices and referral sources; communicate trends and barriers to internal stakeholders.
Help develop and improve SOPs, training materials, and workflows; contribute to workforce planning and capacity modeling.
Recommend process improvements that reduce turnaround times and increase efficiency and scalability.
Champion new technologies and reporting capabilities as the function evolves.