Registered Nurse

CivicMinds, Inc; Concord (NH); On-site; USD 150,000 - 190,000; Full time

Benefits offered by this job

Health insurance

Retirement savings plan

Paid time off

Short-term and long-term disability

Life insurance

AD&D coverage

Employee assistance program

Wellness programs

Professional development

Certification support

Job summary

CivicMinds, Inc. seeks a Director of Inpatient Care Management to provide strategic and operational leadership for care management, utilization review, discharge planning, transitions of care, and population health initiatives across a three-hospital health system.

The role collaborates with executive leadership, physicians, nursing, case management, social work, revenue cycle, and community partners to improve outcomes, optimize resources, reduce readmissions, and strengthen care coordination.

Qualifications

• Bachelor’s degree in Nursing (BSN) or equivalent.
• Master’s degree in a health-related or science field.
• 7–10 years of progressive leadership in care management, case management, and population health.
• At least 5 years of management experience within a hospital or integrated health system.
• Experience leading operations across multiple sites is preferred.
• Professional certifications such as CCM or ACM encouraged.

Responsibilities

• Lead the overall strategy and operations for Care Management and Utilization Review.
• Oversee inpatient and outpatient care management, including discharge planning and care coordination.
• Standardize care management and utilization review processes across settings.
• Lead initiatives to improve quality outcomes, patient experience, throughput, LOS, and cost-effective care.
• Oversee utilization review, clinical documentation, and authorization processes.
• Support denial prevention and appeals strategies.
• Develop initiatives to reduce readmissions and improve transitions of care.
• Collaborate with physicians and documentation teams on accurate patient status determinations.
• Analyze utilization and LOS data to identify improvement opportunities.
• Ensure CMS, Joint Commission, state regulations, and payer requirements compliance.
• Maintain readiness for regulatory surveys, audits, and accreditation reviews.
• Provide leadership, coaching, and development to care management staff.
• Promote interdisciplinary collaboration to address barriers to care.

Skills

Care Management

Population Health

Leadership

Cross-functional collaboration

Regulatory compliance

Education

BSN or equivalent nursing degree

Master’s degree in health-related or science field

Job description

We are seeking an experienced Director of Inpatient Care Management to provide strategic and operational leadership for care management, utilization management, discharge planning, transitions of care, and population health initiatives across a three-hospital health system.

This leader will work closely with executive leadership, physicians, nursing leaders, case managers, social workers, revenue cycle teams, and community partners to improve patient outcomes, optimize resource utilization, reduce avoidable readmissions, and support effective care coordination.

Key Responsibilities

• Lead the overall strategy and operations for Care Management and Utilization Review.
• Oversee inpatient and outpatient care management, including case management, social work, discharge planning, and care coordination.
• Standardize care management and utilization review processes across multiple hospitals and care settings.
• Lead initiatives to improve quality outcomes, patient experience, patient throughput, length of stay, and cost-effective care.
• Oversee utilization review, medical necessity reviews, and authorization processes.
• Support denial prevention and appeals strategies.
• Develop initiatives to reduce readmissions and improve transitions to post-acute care.
• Collaborate with physicians and clinical documentation teams on accurate patient status determinations.
• Analyze utilization and length-of-stay data to identify opportunities for improvement.
• Ensure compliance with CMS, Joint Commission, state regulations, and payer requirements.
• Maintain readiness for regulatory surveys, audits, and accreditation reviews.
• Provide leadership, coaching, and development to care management staff.
• Promote interdisciplinary collaboration to address clinical, psychosocial, and financial barriers to care.

Required Qualifications

• Bachelor’s degree in Nursing (BSN) or equivalent nursing bachelor's degree
• Master’s degree in a health-related or science field
• 7–10 years of progressive leadership experience in:
• Care Management
• Case Management
• Population Health
• At least 5 years of management experience within a hospital or integrated health system
• Experience leading care management operations across multiple sites or hospitals is preferred.
• Comprehensive health, dental, and vision insurance
• Retirement savings and employer contribution opportunities
• Paid time off and paid holidays
• Short-term and long-term disability coverage
• Life insurance and AD&D coverage
• Employee assistance and wellness programs
• Professional development and continuing education opportunities
• Support for relevant professional certifications such as CCM, ACM, or related credentials
• Leadership and career advancement opportunities
• Collaborative, multidisciplinary work environment
• Supportive organizational culture focused on patient outcomes and quality improvement