Nurse Manager, Inpatient Case Management & Care Coordination

IHA; Springfield (MA); On-site; USD 120,000 - 180,000; Full time

Job summary

Mercy Medical Center in Western Massachusetts is seeking a Nurse Manager for Case Management to lead inpatient care coordination and utilization management. This role partners with physicians, hospital leadership, and system stakeholders to ensure high‑quality, cost‑effective, patient‑centered care while optimizing throughput and regulatory compliance.

The position requires RN licensure in Massachusetts, a BSN, and at least five years of healthcare leadership experience.

Qualifications

• Active RN license in Massachusetts (or eligible).
• BSN required; MSN or related Master's preferred.
• Minimum 5 years of healthcare experience with 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

RN license

BSN

MSN preferred

Healthcare leadership

Care coordination

Utilization management

Communication

Analytical skills

Change leadership

Education

BSN degree

MSN or related master's

Job description

Mercy Medical Center in Western Massachusetts is seeking a Nurse Manager for Case Management to lead inpatient care coordination and utilization management. This role partners with physicians, hospital leadership, and system stakeholders to ensure high‑quality, cost‑effective, patient‑centered care while optimizing throughput and regulatory compliance.

The position requires RN licensure in Massachusetts, a BSN, and at least five years of healthcare leadership experience.