Interim Director Of Case Management

Interim Director of Case Management Overview

• The Interim Director of Case Management will oversee case management operations during a transitional period at a healthcare organization.
• Provide leadership in utilization review, discharge planning, care coordination, and denial management functions.
• Ensure compliance with CMS regulations and Conditions of Participation for effective case management practices.
• Assess team performance and implement strategies to stabilize operations and improve throughput.
• Collaborate with interdisciplinary teams to enhance patient care and reduce length of stay.
• Work within a large health system environment to drive impactful case management improvements.
• Opportunity to contribute to a dynamic healthcare organization during a critical period of transition.

Interim Director of Case Management Key Responsibilities & Duties

• Lead and manage the case management department, ensuring efficient operations and adherence to regulatory standards.
• Oversee utilization review processes to optimize resource allocation and patient care quality.
• Develop and implement discharge planning protocols to ensure seamless patient transitions.
• Coordinate care across multidisciplinary teams to achieve optimal patient outcomes.
• Monitor and manage denial management functions to minimize financial impact.
• Evaluate team performance and provide guidance to enhance operational efficiency.
• Collaborate with leadership to align case management strategies with organizational goals.
• Ensure compliance with InterQual and MCG criteria for effective case management practices.

Interim Director of Case Management Job Requirements

• Associate of Science (AS) degree required; BSN or higher preferred.
• RN licensure in California or relevant social work credentials.
• Minimum of 2 years of acute-care case management leadership experience.
• Familiarity with CMS regulations, Conditions of Participation, and InterQual/MCG criteria.
• ACM or CCM certification is highly desirable.
• Proven ability to assess team performance and implement operational improvements.
• Strong leadership skills in a large health system environment.
• Comfortable stepping into an interim capacity and delivering immediate impact.