Case Management Nurse Manager

Case Management Nurse Manager Overview

• The Case Management Nurse Manager oversees case management operations, ensuring compliance with regulatory standards and organizational goals.
• This role includes staff supervision, performance evaluations, and the development of educational programs for continuous improvement.
• Collaborates with other departments to meet organizational priorities and ensures effective communication across teams.
• Manages department budgets, monitors expenses, and provides financial reports to leadership.
• Serves as a resource and liaison between case management and other hospital departments.
• Ensures compliance with state and federal requirements, including Medicare Conditions of Participation.
• Provides direction for case management rounds and supports staff in adapting to changes.
• Maintains confidentiality and protects sensitive data, including patient and personnel information.

Case Management Nurse Manager Key Responsibilities & Duties

• Supervise case management staff, including hiring, onboarding, and performance evaluations.
• Develop and implement monthly staffing plans and coordinate daily operations.
• Provide training and guidance to staff on documentation improvement and software utilization.
• Collaborate with departments to meet organizational goals and regulatory requirements.
• Monitor and analyze data related to case management goals and performance metrics.
• Ensure compliance with Medicare Conditions of Participation and other relevant regulations.
• Represent case management in hospital-wide committees and external healthcare community meetings.
• Develop and manage department budgets, providing explanations for variances as needed.

Case Management Nurse Manager Job Requirements

• Bachelor of Science in Nursing (BSN) required; ACMA certification preferred.
• Minimum of five years of RN experience and two years in case management or related areas.
• Current RN licensure and Basic Life Support (BLS) certification required.
• Strong knowledge of clinical processes, DRG, ICD9, and CPT codes.
• Proficiency in interpreting hospital charts and regulatory criteria.
• Ability to develop and implement case management processes and educational programs.
• Experience in managing budgets and financial reporting.
• Excellent communication and leadership skills to guide and support teams effectively.