Manager – Clinical Resource / Case Management - MGRCM 0603 NS#03
NavitasPartners•Barnstable, MA
•Onsite
About The Position
The Manager of Clinical Resource / Case Management is responsible for overseeing daily operations and providing clinical leadership for Case Management, Utilization Review, and Social Work services. This role supports care coordination, discharge planning, and high-risk patient management while ensuring compliance with regulatory standards and optimizing patient outcomes. The position also plays a key role in staff development, process improvement initiatives, and collaboration across multidisciplinary teams.
Requirements
- Active Registered Nurse (RN) license (state-specific)
- Bachelor of Science in Nursing (BSN) required
- Minimum 3 years of recent acute care clinical experience
- Minimum 5 years of Case Management experience in an acute care setting
- Minimum 2 years of process improvement experience
- Working knowledge of utilization review systems (e.g., InterQual® or equivalent)
- Knowledge of healthcare regulations and reimbursement processes (e.g., CMS)
- Experience developing and delivering education programs
- Strong computer skills (Windows-based applications)
- Excellent organizational, analytical, and communication skills
Nice To Haves
- Master’s degree in Nursing or related field
- Certification in Case Management (CCM) and/or Clinical Documentation Integrity (CDI)
- Prior management or supervisory experience
- Experience leading multidisciplinary healthcare teams
Responsibilities
- Oversee day-to-day operations of Case Management and Social Work teams
- Manage staff scheduling, workflow, and performance evaluations
- Support clinical documentation processes in collaboration with leadership
- Mentor, coach, and develop team members to enhance performance
- Conduct patient rounds to identify discharge barriers and facilitate transitions of care
- Ensure effective discharge planning and utilization management
- Collaborate with physicians, nurses, and interdisciplinary teams
- Develop and deliver continuing education programs
- Provide onboarding and role-specific training for new staff
- Educate clinical teams on utilization review and discharge planning processes
- Monitor compliance metrics and identify performance gaps
- Develop dashboards and reports to track outcomes
- Lead process improvement initiatives
- Ensure adherence to regulatory standards and best practices
- Analyze operational and departmental performance metrics
- Utilize case management systems to drive improvements
- Present data-driven recommendations to leadership
Benefits
- Most competitive pay for every position
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Manager
