Director of Case Management & Care Coordination

Prime Healthcare; Northern (KY); Hybrid; USD 85,000 - 124,000; Full time

Job summary

Prime Healthcare is seeking a Director of Case Management (RN or LCSW) in a full-time, days shift. You will lead Case Management, Utilization Review, Social Work, Care Coordination, and Discharge Planning to optimize resources and patient outcomes.

Responsibilities include driving throughput, collaborating with physicians, payers, and interdisciplinary teams, and ensuring CMS and payer compliance. Minimum 5 years in case management with licensure in your state; MSW preferred.

Qualifications

• Licensed clinician in your state.
• Grandfathered prior to 1 April 2015; 5+ years post graduate in a social work program for LCSW.
• Minimum 5 years' experience in a Case Management role.
• Analytical ability for identifying problems and evaluating data.
• Basic to intermediate computer skills.

Responsibilities

• Lead Case Management, Social Work, Utilization Review, and Discharge Planning teams.
• Drive patient throughput, LOS, utilization management, readmissions, and denials prevention.
• Partner with physicians, nursing, payers, and interdisciplinary teams to remove barriers to care.
• Monitor performance metrics and lead quality and process improvements.
• Ensure CMS, accreditation, regulatory, and payer compliance.
• Collaborate to optimize resource use and discharge planning.

Skills

Licensed Clinician

RN or LCSW

Case Management

Data analysis

Computer skills

Analytical thinking

Education

MSW (Master of Social Work)

Job description

Prime Healthcare is seeking a Director of Case Management (RN or LCSW) in a full-time, days shift. You will lead Case Management, Utilization Review, Social Work, Care Coordination, and Discharge Planning to optimize resources and patient outcomes.

Responsibilities include driving throughput, collaborating with physicians, payers, and interdisciplinary teams, and ensuring CMS and payer compliance. Minimum 5 years in case management with licensure in your state; MSW preferred.