Case Management Manager: Lead Care Transitions & Outcomes

Pascack Valley Medical Center; Westwood (NJ); On-site; USD 90,000 - 120,000; Full time

Job summary

Pascack Valley Medical Center in Westwood, NJ, is seeking a Case Management Manager to lead the department and coordinate case management, social work, utilization review, and transitions of care.

You will collaborate with physicians, Revenue Cycle, and hospital leadership to improve patient outcomes, optimize length of stay, ensure regulatory compliance, and support efficient care delivery.

Qualifications

• RN license required for nursing candidates.
• Associate degree or higher in Nursing, or Bachelor’s degree in Social Work.
• One year or more of Case Management leadership experience.
• Two or more years of acute hospital-based case management experience (preferred).
• Certification in case management (ACM or CCM) (preferred).

Responsibilities

• Support daily Case Management operations and initiatives focused on length of stay, readmissions, utilization management, and transitions of care.
• Partner with physicians and internal and external physician advisors on utilization review, medical necessity, and appropriate level of care.
• Monitor and analyze key performance indicators, including length of stay and readmission data, and implement workflows to improve performance.
• Collaborate with Revenue Cycle and other departments on medical necessity reviews, audits, denials, and related improvement initiatives.
• Ensure departmental practices align with applicable federal and state regulations, standards of practice, and organizational requirements.
• Support Case Management staff through regular communication, education, workflow development, and training on regulatory requirements and emerging trends.
• Partner with the Director of Case Management to drive operational improvements and achieve hospital and organizational goals.

Skills

Case Management leadership

Healthcare operations coordination

Education

Associate degree in Nursing

Bachelor’s degree in Social Work

Job description

Pascack Valley Medical Center in Westwood, NJ, is seeking a Case Management Manager to lead the department and coordinate case management, social work, utilization review, and transitions of care.

You will collaborate with physicians, Revenue Cycle, and hospital leadership to improve patient outcomes, optimize length of stay, ensure regulatory compliance, and support efficient care delivery.