Manager - Case Management - RN - Coordinated Care

ummc; Jackson (MS); On-site; USD 100,000 - 130,000; Full time

Job summary

Adult Coordinated Care at Main Campus Jackson seeks a Manager - Case Management - RN - Coordinated Care to supervise daily tasks of an assigned team and coordinate management activities including hiring, performance evaluations, scheduling, and data reporting.

The role oversees utilization reviews, discharge planning, and patient placement while promoting quality patient care, cost efficiency, and continuous quality improvement. RN license and CCM/ACM certifications are required.

Qualifications

• RN license valid and current.
• Certified Case Manager (CCM) and Accredited Case Manager (ACM) certifications required.
• Minimum four years nursing experience in case management, utilization review, or discharge planning, including one year in nursing leadership.
• Strong knowledge of utilization review, discharge planning, and managed care reimbursement.
• Excellent interpersonal, verbal and written communication; ability to analyze data and prepare reports.

Responsibilities

• Determines staffing needs and participates in hiring activities with administration.
• Coordinates scheduling and directs the work of case managers.
• Identifies key competencies and develops evaluation processes from hiring onward.
• Evaluates employee performance through outcomes and practices.
• Provides daily supervision, including coaching, training and data collection.
• Mentors staff to support professional development within the department.
• Develops work instructions and assists with complex assignments.
• Documents findings and tracks data to evaluate benchmarks and metrics.
• Ensures efficient resource use and resolves barriers impacting productivity.
• Serves as a resource for complex patient placement issues.
• Supports staff development activities with department leadership.
• Provides backup coverage for case managers to maintain continuity.

Skills

Case management

Nursing leadership

Data analysis

Communication skills

Resource optimization

Education

RN license

CCM certification

ACM certification

Tools

Medical coding (ICD-10, CPT)

Clinical software

Data reporting tools

Job description

Job Requisition ID:

R00052746

Job Category:

Nursing

Organization:

Adult Coordinated Care

Location/s:

Main Campus Jackson

Job Title:

Manager - Case Management - RN - Coordinated Care

Job Summary:

Functions as the direct supervisor for daily tasks of an assigned team of Case Managers. Serves as an experienced clinical professional, coordinating management activities including employee selection, performance evaluations, scheduling, team outcomes management, and data collection and reporting. Oversees utilization reviews, case coordination, discharge planning, and patient placement. Identifies and removes barriers to promote effective resource utilization and efficient team productivity.

Education & Experience

Education and Experience Required:

Four (4) years of nursing experience in case management, utilization review, utilization management, or discharge planning including one (1) year of nursing leadership experience.

Certifications, Licenses, or Registration required:

Valid RN license. Certified Case Manager from the Certified Case Management Commission and Accredited Case Manager from the American Case Management Association

Knowledge, Skills & Abilities

Knowledge, Skills, and Abilities:

Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and coding systems, including ICD-10, CPT, and DSM-IV. Effective interpersonal, verbal, and written communication skills, including negotiation and collaboration. Ability to analyze data, prepare reports, and identify process improvements. Demonstrates sound judgment and ensures consistent application of medical necessity guidelines across the team. Committed to quality patient care, customer service, safety, cost efficiency, and continuous quality improvement (CQI). Proficient in the use of computers and related software applications.

Responsibilities

• Determines staffing needs, establishes required qualifications and skill sets, and participates in hiring activities in collaboration with administration and other stakeholders.
• Coordinates departmental activities by scheduling work assignments, establishing priorities, and directing the work of case managers.
• Identifies key competencies for case management staff and develops processes to assess competencies from hiring through ongoing performance evaluations.
• Evaluates employee performance through review of work assignments, outcomes, and work practices.
• Provides daily supervision, including hiring support, workload determination, assignment delegation, training oversight, coaching, performance evaluation, and data collection and reporting.
• Provides coaching and mentorship to staff to support professional development within the department.
• Develops and communicates work instructions and assists staff with complex or unusual assignments.
• Documents findings, plans, and actions in accordance with departmental guidelines and standards; tracks and analyzes data to evaluate benchmarks and performance metrics.
• Ensures efficient resource utilization by identifying and removing barriers that impact team productivity.
• Serves as a resource for resolving complex patient placement issues.
• Supports ongoing staff development activities in collaboration with the department director.
• Provides backup coverage for case managers as needed to ensure departmental goals and operational continuity are maintained.

The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-