Care Management Director - Pediatric Transitions Leader

Medix; Phoenix (AZ); On-site; USD 95,000 - 130,000; Full time

Job summary

Medix is seeking a Care Management Director in Phoenix, AZ, to provide strategic direction and operational oversight for enterprise-wide Care Coordination including Inpatient Care Management, Utilization Management, and Social Work.

The role requires 10+ years in Case Management or Social Work, with 5+ years in leadership in an acute care setting; pediatric experience is preferred and expertise in revenue cycle and coding is essential.

Qualifications

• Required: Bachelor's degree in Nursing, Social Work, Healthcare Administration, Public Health, or related field.
• Preferred: Master's degree in Nursing, Management, Organizational Development, Healthcare Administration, or Social Work.

Responsibilities

• Strategic Leadership & Compliance: Partner with executive leadership to set KPIs and direct operations for Case Management, Utilization Management, and Social Work to ensure EMTALA and evidence-based practices.
• Operational Oversight & Quality: Assess efficiency, establish control mechanisms for scheduling, verifications, and financial clearances; drive quality improvements.
• Financial & Resource Management: Manage budgets; analyze metrics; evaluate technologies to improve care delivery and vendor partnerships.
• Interdisciplinary Collaboration: Coordinate with Nursing, Managed Care, Revenue Cycle, HIM, and Medical Group leadership to streamline transitions.
• Team Development & Mentorship: Build a high-performing team with clear expectations and targeted education.

Skills

Leadership

Case Management

Social Work

Cross-functional collaboration

Education

Bachelor's degree

Master's degree

Tools

MCG

InterQual

Allscripts Care Management (ACM)

Milliman guidelines

Job description

Medix is seeking a Care Management Director in Phoenix, AZ, to provide strategic direction and operational oversight for enterprise-wide Care Coordination including Inpatient Care Management, Utilization Management, and Social Work.

The role requires 10+ years in Case Management or Social Work, with 5+ years in leadership in an acute care setting; pediatric experience is preferred and expertise in revenue cycle and coding is essential.