Care Management Manager
About The Position
The Manager of Care Management I leads and collaborates on care management operations across utilization review, acute and emergency department care, and ambulatory and community settings, ensuring alignment with system-level strategies. The role oversees multiple disciplines at care sites within a market or region and works with medical staff, nursing, clinical, and revenue cycle leaders to optimize patient care and financial performance. The manager oversees departmental services including social work, complex care planning, transitions of care, and utilization management; ensures compliance with state, national, and regulatory requirements; and fosters workforce development. The position contributes to enterprise-wide strategies for safe, high-quality, patient-centered, and equitable care and may require travel to various locations for operational oversight and leadership support. The position oversees staffing, escalations, barrier triage, and coordination with compliance and legal to support care delivery. Department operations are primarily Monday through Friday in non-24-hour service areas, with possible weekend support for escalations, or the role may have a small number of direct reports in 24-hour departments based on reporting structure. The manager leads patient satisfaction programs and mentors staff in service excellence; represents care management with healthcare executives, post-acute providers, multidisciplinary teams, and outreach programs; and leads process improvement, quality assurance, change management, and continuous improvement efforts. The position reports to the Care Management Director.
Requirements
- Current Registered Nurse (RN) license in the state of practice, or Licensed Clinical Social Worker (LCSW), Licensed Master of Social Work (LMSW), or applicable license in the state of practice with relevant experience at that licensure.
- Bachelor of Science in Nursing (BSN) or Master of Social Work (MSW) from an accredited institution; degree verification is required.
- Care Management Certification within 24 months of hire or promotion.
- Demonstrated care management experience.
Nice To Haves
- Previous management experience in hospital care management, utilization review, ambulatory care management, ambulatory utilization review, or a related area.
Responsibilities
- Lead and collaborate on care management operations across utilization review, acute and emergency department care, and ambulatory and community settings.
- Oversee multiple disciplines across care sites within a market or region.
- Collaborate with medical staff, nursing, clinical, and revenue cycle leaders to optimize patient care and financial performance.
- Manage departmental services including social work, complex care planning, transitions of care, and utilization management.
- Ensure compliance with state, national, and regulatory requirements and foster workforce development.
- Oversee staffing, escalations, barrier triage, and coordination with compliance and legal to support care delivery.
- Drive patient satisfaction programs and mentor staff in service excellence.
- Represent care management with healthcare executives, post-acute providers, multidisciplinary teams, and outreach programs to improve care transitions and service integration.
- Drive high-impact change initiatives, monitor key performance indicators, and lead quality assurance efforts.
- Lead strategic initiatives supporting enterprise KPIs and outcomes, manage transitions, and involve staff in decision-making.
- Implement best practices, drive quality enhancements, and optimize operational effectiveness.
- Travel to various locations for operational oversight and leadership support as needed.
Benefits
- Benefits eligible.
- Generous benefits package with programs intended to support wellness across health, security, connection, and engagement.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
