RN Case Management Leader - Clinical Operations

Northeast Georgia Health System; Braselton (GA); On-site; USD 90,000 - 120,000; Full time

Job summary

Northeast Georgia Health System seeks an experienced nurse leader to supervise day-to-day Case Management operations and guide the interdisciplinary team in facilitating patient care. You will monitor utilization, ensure education and competency, and uphold standards across the CM staff to optimize outcomes.

In this role you will work with physicians and hospital departments on discharge planning, transitions of care, and adherence to patient safety goals.

Qualifications

• GA licensed RN in good standing.
• Associate degree required.
• Minimum management or supervisory experience preferred.
• Experience in case management, utilization management, or discharge planning.
• Knowledge of Federal and State regulations governing healthcare.

Responsibilities

• Supervise the day-to-day operations of Case Management staff.
• Serve as a clinical resource for UR policies and government insurance programs.
• Develop, update, and communicate CM policies and procedures to ensure reimbursement.
• Assist in recruiting, onboarding, and ongoing staff training.
• Develop and perform quality audits on CM staff monthly.
• Set and monitor performance KPIs; provide feedback and disciplinary action as needed.
• Collaborate with departments to facilitate transition planning and continuity of care.
• Educate physicians on discharge planning policies and practices.

Skills

Supervisory/managerial experience

Communication

Process development

Data analysis

Cross-functional collaboration

Education

GA RN license

Associate degree

Tools

Microsoft Excel

Microsoft Word

Job description

Northeast Georgia Health System seeks an experienced nurse leader to supervise day-to-day Case Management operations and guide the interdisciplinary team in facilitating patient care. You will monitor utilization, ensure education and competency, and uphold standards across the CM staff to optimize outcomes.

In this role you will work with physicians and hospital departments on discharge planning, transitions of care, and adherence to patient safety goals.