Nurse Director Case Management

Nurse Director Case Management Overview

• The Nurse Director Case Management oversees hospital case management operations, ensuring compliance, efficiency, and quality in care coordination and utilization management.
• Lead a multidisciplinary team, including case managers, social workers, and utilization review staff, to achieve departmental goals.
• Collaborate with the CFO to align clinical and financial outcomes, ensuring effective resource utilization.
• Develop and implement strategies to improve length of stay, discharge efficiency, and reduce readmissions.
• Ensure compliance with healthcare regulations, HIPAA, and payer requirements.
• Provide leadership in departmental budgeting, staffing plans, and performance management.
• Foster a culture of continuous improvement and staff development within the department.
• Work onsite to ensure seamless operations and effective team collaboration.

Nurse Director Case Management Key Responsibilities & Duties

• Oversee case management, utilization review, and social work functions within the hospital.
• Develop and manage departmental budgets, ensuring optimal resource allocation.
• Lead hiring, training, and performance evaluations for departmental staff.
• Implement strategies to reduce avoidable days and improve documentation processes.
• Ensure compliance with healthcare regulations and payer requirements.
• Collaborate with interdisciplinary teams to enhance patient care coordination and discharge planning.
• Support internal and external audits, ensuring readiness and compliance.
• Report departmental performance metrics and outcomes to the CFO.

Nurse Director Case Management Job Requirements

• Active Registered Nurse (RN) license required.
• Minimum of 4 years of hospital case management experience, with 5 years preferred.
• ACMA Accredited Case Manager certification or willingness to obtain within two years.
• Proven leadership experience in an acute care hospital setting.
• Experience managing case managers, social workers, and utilization review teams.
• Strong understanding of healthcare regulations, HIPAA, and compliance requirements.
• Ability to develop and manage departmental budgets and staffing plans.
• Willingness to relocate or commute to the designated location.