Manager Inpatient Care Management

CentraState Healthcare System•Freehold, NJ

4d•$97,500 - $165,750•Onsite

About The Position

The Manager Inpatient Care Management is responsible for the oversight of daily operations of Care Management and Social Work functions, including utilization management, care coordination, and discharge planning. This role ensures the delivery of medically appropriate, cost-effective care while maintaining compliance with regulatory and accreditation requirements. The Manager collaborates with medical staff, interdisciplinary teams, and external providers to optimize patient progression, reduce length of stay and denials, and ensure timely and appropriate transitions of care. The role is accountable for staff performance, operational effectiveness, and achievement of key departmental outcomes.

Requirements

Bachelor's degree in Nursing Or Social Work required.
Minimum of 3–5 years of acute care case management or utilization review experience required.
Experience with utilization management regulations and discharge planning required.
Valid NJ RN License required, Or Valid Licensed Social Worker required.
Knowledge of relevant and state utilization review and appeals requirements
Strong professional, organizational, and interpersonal skills to effectively relate with all members of the healthcare team.
Rapid cycle change or clinical performance improvement expertise
Data and computer skills
Excellent communication, negotiation, and conflict resolution skills

Nice To Haves

Master's degree in Nursing Or Social Work preferred.
Prior leadership experience preferred.
Case Management Certification (CCM, ACM), preferred

Responsibilities

Oversees daily operations of Care Management and Social Work, including utilization review, care coordination, and discharge planning.
Supervises and supports case managers and social workers, including staffing, work assignments, and performance management.
Ensures timely and appropriate utilization review processes, including medical necessity determinations, payer communication, and escalation to Physician Advisors.
Monitors compliance with CMS regulations and utilization management requirements, including Condition Code 44, MOON, IMM, and HINN notices.
Oversees documentation standards and completion of utilization reviews, payer communications, and physician advisor referrals in accordance with policy.
Partners with medical staff leadership and Physician Advisors to address level of care concerns, denials, and length of stay opportunities.
Leads interdisciplinary collaboration to facilitate progression of care and timely discharge planning.
Monitors and drives performance in key metrics, including length of stay, avoidable days, discharge timeliness, and denial rates.
Identifies barriers to progression of care and implements strategies to improve throughput and reduce delays.
Conducts audits and reviews to ensure quality, regulatory compliance, and adherence to departmental standards.
Leads process improvement initiatives to enhance care management workflows and patient flow.
Establishes productivity standards and ensures appropriate workload distribution across the team.
Participates in hospital, medical staff, and system committees, including the Utilization Review Committee.
Maintains collaborative relationships with internal departments and external providers across the continuum of care.
Maintains clinical competency to support departmental needs, including coverage as needed.
Other duties as assigned by management

Benefits

Medical, Dental, Vision, Prescription Coverage (30 hours per week or above for full-time and part-time team members)
Life & AD&D Insurance
Long-Term Disability (with options to supplement)
403(b) Retirement Plan with employer match
401(a) Retirement Plan with employer contribution
PTO
Tuition Reimbursement
Well-Being Rewards
Employee Assistance Program (EAP)
Fertility Coverage, Healthy Pregnancy Program
Flexible Spending & Commuter Accounts
Pet, Home & Auto, Identity Theft and Legal Insurance
Growth Opportunity and Workforce Development Initiatives
Continuing Education / Onsite Training
A warm, welcoming company culture based upon mutual respect and a collaborative goal of providing excellent patient care
Concierge Services with Work & Family Benefits