Manager - Case Management

Endocrine News; Town of Florida (NY); On-site; USD 90,000 - 120,000; Full time

Job summary

Memorial Healthcare System in Hollywood, FL, seeks a Manager of Case Management to lead day-to-day discharge planning and care coordination. You will ensure regulatory compliance and drive patient flow with multidisciplinary teams.

Candidates should have 3+ years in case management with leadership, RN or BSN, and familiarity with InterQual or Milliman guidelines.

Qualifications

• Minimum of 3 years in case management with at least 2 years in leadership.
• RN licensure or BSN degree required; Case Management certification preferred.
• Knowledge of State and Federal discharge planning regulations and CMP requirements.
• Familiarity with InterQual or Milliman guidelines.

Responsibilities

• Oversee and coordinate daily case management and discharge planning activities.
• Ensure care quality and efficiency in alignment with regulatory requirements.
• Collaborate with multidisciplinary teams to optimize patient flow.
• Apply and monitor InterQual or Milliman guidelines in decisions.
• Lead process improvements and performance monitoring.

Education

RN license or BSN

Leadership in case management

Tools

IDX system

Logician

InterQual/Milliman guidelines

Job description

# Manager - Case ManagementHollywood, FloridaHospitalComplexity of Work: Responsible for day-to-day oversight and coordination of case management and discharge planning functions ensuring patient care meets quality and efficiency standards while aligning with regulatory requirements. This role requires an understanding of payer guidelines and working closely with multi-disciplinary teams to optimize patient flow. Requires critical thinking and effective communication (verbal and written) skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Knowledge of State and Federal regulations governing discharge planning conditions of participation, hospital information systems (e.g., logician and IDX), staff development techniques, and performance improvements processes. Strong background in clinical decision making, medical criteria, and discharge planning. Must be proficient with Interqual or Milliman guidelines and use. Proficient in process improvement, and performance monitoring.Required Work Experience: Minimum of three (3) years of case management experience and, at least, two (2) years of leadership experience within case management.Other Information: Additional Education Info: Graduate of an accredited Registered/Professional Nursing program or a Bachelor's degree in Nursing (BSN).Additional Certification Info: Certification in Case Management preferred. Memorial Healthcare System is a community of caregivers dedicated to delivering quality patient- and family-centered care. This passion for caring extends to our teammates, who support one another and create heartfelt connections that last a lifetime. We are one family at the heart of exceptional care. Join us as we elevate the well-being of everyone we touch. **#teamMHSflorida**Back to top View Similar Jobs