Regional Director Case Management

Overview

• Lead regional case management operations across a healthcare system, ensuring effective care transitions and compliance with regulatory requirements.
• Collaborate with hospitals to optimize medical necessity reviews, utilization management, and discharge planning processes.
• Address challenges such as limited post-acute resources, social complexities, and regulatory constraints in rural healthcare settings.
• Strengthen physician relationships and support frontline teams to improve patient outcomes and operational stability.
• Develop strategies to reduce avoidable delays, readmissions, and improve transfers between hospitals.
• Align organizational standards with the unique needs of rural healthcare environments.
• Ensure compliance with Critical Access Hospital regulations and lean staffing models.
• Drive initiatives to enhance patient care quality and operational efficiency.

Key Responsibilities & Duties

• Oversee case management operations across multiple hospitals within the healthcare system.
• Implement strategies to ensure compliant length-of-stay management and effective care transitions.
• Support Critical Access Hospitals with regulatory requirements and staffing model optimization.
• Collaborate with hospital teams to strengthen utilization review and discharge planning processes.
• Address social complexities impacting patient care, such as transportation and housing barriers.
• Develop and maintain strong relationships with physicians and healthcare providers.
• Monitor and improve transfers between hospitals within the healthcare system.
• Ensure alignment of organizational standards with rural healthcare operational realities.

Job Requirements

• Bachelor of Science (BS) degree in a relevant field.
• Minimum of 5 years of experience in case management or healthcare operations.
• Strong knowledge of Critical Access Hospital regulations and rural healthcare challenges.
• Proven ability to lead and support hospital teams in complex environments.
• Experience in utilization review, discharge planning, and medical necessity processes.
• Excellent communication and relationship-building skills with physicians and healthcare providers.
• Ability to address social complexities impacting patient care effectively.
• Commitment to enhancing patient care quality and operational efficiency.