Nurse Manager, Case Management

Trinity Health; Springfield (MA); On-site; USD 110,000 - 150,000; Full time

Job summary

Mercy Medical Center in Western Massachusetts seeks a Nurse Manager – Case Management to provide strategic and operational leadership for inpatient care coordination, case management, and utilization management services. You will partner with physicians, hospital leadership, and system stakeholders to ensure high‑quality, cost‑effective, patient‑centered care.

You will lead teams, promote evidence‑based practice, oversee utilization processes, and drive patient flow initiatives, while

Qualifications

• Active Registered Nurse license in Massachusetts
• BSN required; MSN or Master’s in related field preferred
• Minimum 5 years of healthcare experience, including leadership or management
• Experience in care coordination, case management, utilization management, or patient flow
• Strong communication, analytical, and change‑leadership skills

Responsibilities

• Lead Care Coordination and Case Management teams, including staff development, performance management, and engagement
• Promote evidence‑based nursing practice, patient safety, and interdisciplinary collaboration
• Oversee utilization management processes, level‑of‑care determinations, concurrent reviews, denials management, and appeals
• Collaborate with Physician Advisors, Finance, Revenue Integrity, Patient Access, and Compliance teams
• Monitor CMS and payer compliance (IMM/MOON, authorizations, documentation standards)
• Drive patient flow initiatives to support timely admissions, transitions of care, and discharge planning
• Analyze data, trends, and outcomes to support quality improvement and financial stewardship
• Participate in hospital and system‑wide committees and strategic initiatives
• Support effective use of EPIC (TogetherCare) and reporting tools

Skills

Leadership

Communication

Analytical skills

Change leadership

Care coordination

Interdisciplinary collaboration

Education

BSN

MSN or related field preferred

Tools

EPIC

Reporting tools

Job description

Mercy Medical Center in Western Massachusetts seeks a Nurse Manager – Case Management to provide strategic and operational leadership for inpatient care coordination, case management, and utilization management services. You will partner with physicians, hospital leadership, and system stakeholders to ensure high‑quality, cost‑effective, patient‑centered care.

You will lead teams, promote evidence‑based practice, oversee utilization processes, and drive patient flow initiatives, while