RN Case Management Lead - Day Shift, Full-Time

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

Job summary

Mercy Medical Center in Springfield, MA, seeks a Nurse Manager – Case Management to provide strategic and operational leadership for inpatient care coordination, case management, and utilization management. You will lead teams, collaborate with physicians and hospital leadership, and drive throughput and regulatory compliance.

role emphasizes evidence-based practice, staff development, and use of EPIC (TogetherCare) and reporting tools to optimize patient care and outcomes.

Qualifications

• RN license in Massachusetts (Active).
• BSN required; MSN or 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

Staff development

Performance management

Communication

Analytical skills

Change leadership

Education

BSN

MSN or related field

Tools

EPIC (TogetherCare)

Reporting tools

Job description

Mercy Medical Center in Springfield, MA, seeks a Nurse Manager – Case Management to provide strategic and operational leadership for inpatient care coordination, case management, and utilization management. You will lead teams, collaborate with physicians and hospital leadership, and drive throughput and regulatory compliance.

role emphasizes evidence-based practice, staff development, and use of EPIC (TogetherCare) and reporting tools to optimize patient care and outcomes.