Manager Case Management
About The Position
Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Manager, Case Management, is responsible for the overall leadership, operations, and performance of the Care Management Department. This role provides strategic and operational oversight to ensure delivery of high-quality, patient-centered care across the continuum. The Manager leads interdisciplinary collaboration, drives regulatory compliance, and ensures alignment with organizational goals related to patient flow, length of stay, and discharge planning. The Manager is accountable for departmental outcomes, staff performance, program development, and continuous improvement initiatives while fostering a culture of accountability, engagement, and professional excellence.
Requirements
- RN or Social Worker with current, active, unrestricted RN license in Maine OR active, unrestricted Social Work License in Maine
- 5+ years of relevant clinical or care management experience
- Live in a daily commute distance of Presque Isle ME (this is not a remote-eligible role)
- Willing/able to work full time (Monday – Friday) at a hospital location in Presque Isle ME (this is not a remote-eligible role)
Nice To Haves
- Leadership or supervisory experience
Responsibilities
- Provides leadership and oversight of daily operations and long-term strategic direction for the Care Management Department
- Develops, implements, and evaluates operational plans to achieve departmental and organizational objectives
- Ensures effective coordination of care across the continuum through interdisciplinary collaboration
- Leads process improvement initiatives to optimize patient throughput, reduce length of stay, and improve care transitions
- Identifies, evaluates, and resolves complex operational and clinical issues
- Ensures delivery of quality care in accordance with regulatory requirements, hospital policies, and professional standards
- Oversees staffing models, scheduling processes, and resource allocation to meet operational demands
- Leads recruitment, hiring, onboarding, and retention strategies for Care Management staff
- Provides coaching, performance management, and accountability for assigned team members
- Establishes clear performance expectations and conducts routine performance evaluations
- Fosters a culture of engagement, collaboration, and professional development
- Serves as a subject matter expert for Care Management practices
- Promotes evidence-based practice, clinical excellence, and ongoing professional development
- Ensures staff competency and compliance with regulatory standards
- Ensures departmental compliance with CMS, regulatory, and accreditation requirements
- Oversees quality monitoring activities, audits, and performance improvement initiatives
- Reviews, investigates, and resolves incidents, safety concerns, and risk events
- Promotes a culture of safety, accountability, and non-punitive reporting
- Monitors key performance indicators, including length of stay, avoidable days, and throughput metrics
- Manages departmental performance, including productivity, quality outcomes, and resource utilization
- Participates in budget development, monitoring, and fiscal accountability for the department
- Aligns departmental operations with organizational financial and strategic goals
- Partners with physicians, nursing leadership, and interdisciplinary teams to support care coordination and patient outcomes
- Serves as a key liaison between Care Management and hospital or system leadership
- Leads and participates in committees, initiatives, and organizational projects
- Exercises independent judgment in operational, clinical, and personnel decisions
- Decisions have impact at the departmental and organizational level
- Responsible for achieving performance outcomes and implementing strategic initiatives
- Performs other related duties as assigned to support departmental and organizational priorities
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
