Manager, Case Management

Jobtailor; Springfield (OH); On-site; USD 90,000 - 130,000; Full time

Job summary

Jobtailor is seeking a senior Care Management leader to oversee daily operations, standardize practices, and drive improvements in patient outcomes and transitions. This role partners with physicians and hospital leadership to optimize utilization and compliance.

The ideal candidate will have RN or SW licensure, advanced certifications, and 3+ years in acute care management, with a strategic focus on safety, quality, and cost efficiency.

Qualifications

• BLS Basic Life Support – American Heart Association (required).
• RN license in state of practice or licensed as a Social Worker (required).
• Accredited Case Manager Certification (ACM), Certified Case Manager (CCM), or ANCC Nursing Case Management board certification (preferred).
• Bachelor of Science in Nursing or Social Work (required).
• Master’s in Nursing, Social Work, or Healthcare Administration (preferred for BSMH, required for RSFH).
• 3 years of recent acute hospital care management experience (required).
• Ability to ensure compliance with federal, state, and local regulations and accreditation requirements.

Responsibilities

• Oversight of day-to-day care management operations and resources.
• Standardize practices for care planning, length-of-stay management, and transitions.
• Monitor data and take action to improve outcomes and reduce barriers.
• Educate staff on progression of care and safe, timely transitions.
• Collaborate with system leaders to optimize utilization and cost efficiency.
• Support budget development and cost-reduction initiatives.
• Ensure regulatory and accreditation compliance across the department.

Skills

Care Coordination

Data Monitoring

Advance Care Planning

Length-of-Stay Management

Readmission Prevention

Denial Prevention

Progression of Care

Patient Education

Budget Management

Resource Utilization

Leadership

Collaboration

Communication

Education

Team Management

Education

BSN or MSW

Master’s in Nursing, Social Work, or Healthcare Administration

Job description

Provide day-to-day oversight, coordination, organization, and management of Care Management Department functions and resources
Lead and oversee daily operations of the Care Management Team
Standardize practices for Advance Care Planning, length-of-stay management, readmission prevention, predictive readmission tools, denial prevention, progression of care, daily team rounding, care transitions, and patient satisfaction
Monitor qualitative and quantitative data and take action to mitigate barriers and improve outcomes
Educate care management staff, physicians, nurses, and other care team members on progression of care, level of care, and safe, timely transitions
Support care management education, care coordination, compliance, transition management, and resource utilization
Coordinate proactive care management across the continuum with population health and community health efforts
Collaborate with ambulatory and post-acute providers to ensure seamless care transitions
Partner with physician leadership to optimize the Utilization Management Committee and provide actionable utilization data
Direct personnel resources according to patient and ministry needs
Assist with departmental goals, objectives, strategic plans, and initiatives
Collaborate with nursing, quality, hospitalist, physician advisor, and physician leadership to optimize high-quality, cost-efficient care
Participate in annual budget development and management; identify and achieve cost reductions
Support operational standardization and understand financial impacts of contracts and value-based payment models
Educate staff on healthcare landscape changes, care model innovations, research, and evidence-based practices
Promote service excellence and ensure regulatory and accreditation compliance

Requirements

• BLS Basic Life Support – American Heart Association (required)
• RN License in state of practice or Licensed as a Social Worker in state of practice (required)
• Accredited Case Manager Certification (ACM), Certified Case Manager (CCM), or ANCC Nursing Case Management board certification (preferred)
• Bachelor of Science in Nursing or Social Work (required)
• Master’s in Nursing, Social Work, or Healthcare Administration (preferred for BSMH, required for RSFH)
• 3 years of recent acute hospital care management experience (required)
• Ability to ensure compliance with federal, state, and local regulations and accreditation requirements impacting care management service

Core Competencies

Demonstrates expertise in Care Management, including oversight of operations, compliance with regulations, and effective care transitions. Proficient in utilizing data to improve patient outcomes and manage resources efficiently.

Highest-signal resume keywords

• Care Management Oversight
• Acute Hospital Care Management
• Regulatory Compliance
• Utilization Management
• Patient Satisfaction Improvement

ATS Optimization Keywords

Hard Skills

• Care Coordination
• Data Monitoring
• Advance Care Planning
• Length-of-Stay Management
• Readmission Prevention
• Denial Prevention
• Progression of Care
• Patient Education
• Budget Management
• Resource Utilization

Soft Skills

• Leadership
• Collaboration
• Communication
• Education
• Team Management

Certifications & Qualifications

• BLS Basic Life Support
• RN License
• Accredited Case Manager Certification
• Certified Case Manager
• ANCC Nursing Case Management Board Certification

Industry Keywords

• Healthcare Administration
• Population Health
• Community Health
• Quality Care
• Value-Based Payment Models