RN Case Management Manager - RNCMM 26-06479
About The Position
We are seeking an experienced RN Case Management Manager to lead and oversee Case Management, Utilization Review, and Social Work operations within an acute care setting. This leadership role is responsible for managing day-to-day departmental operations, supporting care coordination and discharge planning initiatives, driving process improvement efforts, and ensuring compliance with regulatory and organizational standards. The ideal candidate will possess strong leadership skills, extensive acute care case management experience, and a proven ability to mentor staff, improve workflows, and collaborate effectively with interdisciplinary healthcare teams.
Requirements
- Bachelor of Science in Nursing (BSN) required.
- Current and active Massachusetts Registered Nurse (RN) License required.
- Minimum 3 years of acute care clinical experience within the past 5 years.
- Minimum 5 years of Case Management experience in an acute care setting.
- Minimum 2 years of process improvement experience.
- Experience developing and presenting professional continuing education programs.
- Strong knowledge of Case Management, Utilization Review, Discharge Planning, and Care Coordination processes.
- Working knowledge of InterQual® or equivalent utilization management systems.
- Knowledge of CMS regulations and healthcare compliance requirements.
- Excellent leadership, coaching, and staff development skills.
- Strong analytical, organizational, and problem-solving abilities.
- Excellent written, verbal, and interpersonal communication skills.
- Proficiency with Windows-based applications and healthcare information systems.
- Ability to manage multiple priorities in a fast-paced healthcare environment.
Nice To Haves
- Master's Degree preferred.
- Certification in Case Management (CCM) or Clinical Documentation Integrity (CDI) preferred.
- Management and/or supervisory experience strongly preferred.
Responsibilities
- Provide day-to-day leadership and management of Case Management and Social Work staff, including scheduling, coaching, and performance evaluations.
- Support operational oversight of Clinical Documentation functions as needed.
- Conduct routine patient care rounds to identify barriers to discharge and facilitate care coordination efforts.
- Develop, implement, and deliver ongoing education programs for Case Managers, Social Workers, and other healthcare professionals.
- Train and onboard new staff members while supporting professional development initiatives.
- Monitor departmental compliance metrics and create performance dashboards to identify opportunities for improvement.
- Lead quality improvement and process enhancement initiatives focused on care coordination, utilization management, and discharge planning.
- Foster collaboration between physicians, nurses, case managers, social workers, and other healthcare team members.
- Analyze program performance metrics and departmental data to drive operational excellence.
- Stay current with industry regulations, utilization management practices, and case management standards.
- Support organizational goals through continuous improvement and evidence-based practice initiatives.
Benefits
- We offer the most competitive pay for every position we cater.
- You will not be blindsided and your salary will be discussed upfront.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
