RN Director of Care Management

Community Health Systems•Key West, FL

About The Position

The Director, Care Management oversees the implementation, development, and management of Care Management and Resource Management programs. The role ensures compliance with regulatory requirements, establishes efficient processes for patient care and discharge planning, and provides leadership to the Care Management team. The Director collaborates with staff, physicians, and community resources to deliver patient-centered care and achieve optimal outcomes. The position provides leadership and direction to departmental staff, oversees staffing and professional development, and collaborates with hospital leadership on strategic planning, budgeting, resource allocation, and long-term planning. It monitors expenditures, evaluates technologies, develops departmental policies and procedures, and supports quality assurance, regulatory compliance, audits, inspections, and accreditation activities. The Director also works with leadership teams to coordinate and improve service delivery, stays current with industry and regulatory developments, and may work in a staff role when required.

Requirements

Bachelor’s degree in Nursing required.
Three to five years of experience in Care Management required.
Registered Nurse license in the state of employment or compact-state licensure required.
Strong leadership, organizational, and communication skills.
Ability to collaborate with interdisciplinary teams and manage cross-functional relationships.
Ability to foster a positive work environment that promotes teamwork, professionalism, and continuous improvement.
Ability to communicate effectively with leadership, team members, and stakeholders.
Ability to work effectively with others, delegate responsibilities, and independently manage tasks while meeting deadlines.
Problem-solving and critical-thinking skills.
In-depth knowledge of industry best practices and regulatory compliance, if applicable.
Strong organizational and time-management skills.
Proficiency with Google and Microsoft platforms, healthcare software systems, and data analysis tools.
Applicants must be authorized to work in the U.S. for any employer; the position is not eligible for immigration sponsorship.

Nice To Haves

Master’s degree preferred.
Three to five years of previous leadership experience preferred.

Responsibilities

Oversee implementation and maintenance of a compliant Care Management program that meets regulatory and accreditation standards.
Provide leadership and direction to staff, promote accountability, and ensure adherence to roles within each employee’s scope of practice.
Conduct chart reviews to evaluate severity of illness and intensity of services for admissions, continued stays, and discharge planning.
Refer cases that do not meet criteria to the Physician Advisor or Utilization Management Committee and ensure appropriate follow-up.
Identify avoidable days and implement communication systems to address and resolve them.
Coordinate discharge planning and social services to comply with federal and state laws and Joint Commission standards.
Liaise with community agencies to provide resources and services for post-hospital placement and support.
Participate in Patient Care Conferences and Length of Stay meetings to support efficient care delivery and discharge planning.
Provide staff mentorship and professional development opportunities; schedule employees, consult leadership about staffing issues, conduct performance evaluations, set goals, and provide feedback.
Collaborate with hospital leadership on departmental strategy, budgets, resource allocation, and long-term planning; monitor expenditures for cost-effective service delivery.
Evaluate and implement technologies to improve operational efficiency.
Develop and implement departmental policies, procedures, and protocols to optimize quality and efficiency.
Ensure regulatory compliance and participate in audits, inspections, and accreditation processes as applicable.
Follow quality control practices to ensure accuracy, consistency, and safety.
Work with leadership teams to coordinate and improve service delivery, and stay current with industry advancements, technologies, and regulatory changes.
May perform staff-role duties when required and meet the competencies established for that job.
Maintain regular and reliable attendance and comply with policies and standards.
Perform other duties as assigned.