RN Director of Care Management

Community Health Systems•Key West, FL

About The Position

The Director of Care Management oversees the implementation, development, and management of the Care Management and Resource Management programs. The role ensures regulatory compliance, establishes efficient patient-care and discharge-planning processes, and provides leadership to the Care Management team. The Director collaborates with staff, physicians, leadership, and community resources to support patient-centered care and optimal outcomes. The Director provides departmental leadership, staff development, scheduling, performance management, strategic planning, budgeting, and resource oversight. The role also develops departmental policies and procedures, monitors service quality and regulatory compliance, participates in audits and accreditation activities, and may work in a staff role when required. The position is based at Lower Keys Medical Center and is scheduled for day-shift hours.

Requirements

Bachelor’s degree in Nursing required.
3–5 years of experience in Care Management required.
Registered Nurse (RN) licensure 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.

Nice To Haves

Master’s degree preferred.
3–5 years of previous leadership experience preferred.

Responsibilities

Oversee implementation and maintenance of an effective, compliant Care Management program that meets regulatory and accreditation standards.
Lead and direct staff, ensuring accountability and adherence to duties 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 functions in compliance 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 leadership, mentorship, and professional development opportunities for departmental staff.
Schedule employees to ensure effective use of resources and consult with leadership about potential staffing issues.
Conduct performance evaluations, set goals, and provide staff feedback on performance and development.
Collaborate with hospital leadership on departmental strategy, budgeting, resource allocation, and long-term planning.
Monitor expenditures to support 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 compliance with relevant regulatory bodies and participate in accreditation processes, audits, and inspections as applicable.
Follow quality-control practices to ensure accuracy, consistency, and safety.
Work with leadership teams to coordinate and improve service delivery.
Stay current with industry advancements, technologies, and regulatory changes.
Perform staff-role duties when required and fulfill responsibilities and competencies established for that role.
Maintain regular and reliable attendance, comply with policies and standards, and perform other duties as assigned.