Manager, Case Management

Southwest General Health Center Inc.; Cleveland (OH); Presencial; USD 90.000 - 120.000; Jornada completa

Descripción de la vacante

Southwest General Health Center in Cleveland, OH is seeking a Manager, Case Management to oversee daily operations, discharge planning, and utilization management. You will mentor staff, establish workflows, and collaborate with physicians, nursing, social work and other teams to ensure timely, safe transitions of care.

This on-site, full-time role requires CCM certification or eligibility, a registered nursing or social work background, and strong leadership, analytical and communication skills

Formación

• CCM certification or eligibility required.
• Strong discharge planning and care coordination skills.
• Experience with utilization management and payer collaboration.
• Knowledge of CMS and Joint Commission standards.
• Active clinical license in good standing.

Responsabilidades

• Oversee daily case management operations.
• Mentor staff and develop workflows.
• Collaborate with physicians, nursing, social work and other teams.
• Monitor performance metrics and accreditation readiness.
• Lead discharge planning and transitions of care.

Conocimientos

Case management

Discharge planning

Utilization management

Managed care

Active clinical license

Leadership

EMR systems

Interdisciplinary collaboration

Communication skills

Educación

Bachelor’s degree in nursing or social work

Master’s degree preferred

Descripción del empleo

Company Description

Southwest General Health Center is a 368-bed, non-profit hospital serving communities in southwestern Cuyahoga, northern Medina, and eastern Lorain counties. Founded in 1920, the organization has a long-standing tradition of community partnership and a strong commitment to improving local health and well-being. The hospital offers state-of-the-art technology and a comprehensive range of medical, surgical, and emergency services, including a Level III trauma center. Patients and families also have access to extensive social services and support groups that address mental, emotional, and spiritual needs. Guided by the mission \"Health is our Passion. Quality is our Focus. Compassion is our Way\", Southwest General emphasizes excellence and individualized care in every service.

Role Description

The Manager, Case Management is a full-time, on-site role located in Cleveland, OH. This role oversees daily case management operations, including discharge planning, utilization management, and coordination of care across the continuum to promote quality, cost-effective outcomes. The manager leads and mentors case management staff, establishes workflows and best practices, and collaborates with physicians, nursing, social work, and other interdisciplinary team members to ensure timely, appropriate transitions of care. Responsibilities include monitoring performance metrics, supporting compliance with regulatory and payer requirements, and optimizing managed care processes. The role also involves developing policies, participating in quality improvement initiatives, and serving as a resource for complex cases and escalation of barriers to discharge.

Qualifications

• Strong case management expertise, including Case Management and Certified Case Manager (CCM or equivalent) credentials or eligibility for certification.


• Proficiency in Discharge Planning to support safe, timely transitions of care and coordination with community resources.


• Experience with Utilization Management, including review processes, documentation, and collaboration with payers.


• Knowledge of Managed Care principles, reimbursement models, and strategies to optimize length of stay and resource use.


• Current, active clinical license (e.g., RN, social work, or related field) in good standing, with hospital or acute care experience.


• Demonstrated leadership skills, including team supervision, coaching, and performance management.


• Strong analytical, organizational, and problem-solving abilities, with comfort using data and EMR systems in decision-making.


• Effective communication and collaboration skills for working with interdisciplinary teams, patients, families, and external partners.


• Bachelor’s degree in nursing, social work, or a related healthcare field required; master’s degree preferred.


• Familiarity with regulatory standards (e.g., CMS, Joint Commission) and hospital quality and safety initiatives.