RN - Nurse Case Management Services Director

Direct Staffing Inc; Phoenix (AZ); On-site; USD 90,000 - 130,000; Full time

Job summary

A leading health care facility in Phoenix, Arizona, is seeking an RN - Nurse Case Management Services Director to manage and implement case management programs. This full-time position requires strong leadership and clinical expertise to enhance patient satisfaction and operational effectiveness. Ideal candidates will have a nursing degree, relevant state RN license, and management experience in healthcare settings.

Qualifications

• At least 2 years of management experience.
• 2 years of direct clinical care with appropriate patient population.
• Strong knowledge required in utilization management and care management.

Responsibilities

• Plan, direct, and monitor case and utilization management programs.
• Ensure development of case management services supporting the organization’s strategic plan.
• Oversight of financial resources for case management, monitor revenue and expenses.

Skills

Problem-solving

Project management

Contract negotiation

Conflict resolution

Communication

Utilization management

Care management

Regulatory standards knowledge

Reimbursement processes knowledge

Education

Bachelor’s degree in nursing or equivalent experience

Master’s degree in nursing or business (preferred)

CCM certification within 3 years (if in ambulatory setting)

Job description

RN - Nurse Case Management Services Director

Full-time

Hospital serving the health care needs of the dynamic and growing East Valley communities of metro Phoenix, Ariz., including Mesa, Gilbert, Apache Junction, Queen Creek, and Fountain Hills. We provide complete acute care services including oncology, women's health, rehabilitation, emergency medicine, surgery, and a nationally recognized Primary Stroke Center. A strong focus is orthopedics. Dedicated to joint replacement procedures, our orthopedic unit is recognized as one of the Top 100 Orthopaedic Programs in the U.S. by The Health Network and HCIA, Inc. Our facility features state-of-the-art technology including: iCare – an extra layer of monitoring in intensive-care units, robotic surgery, electronic medical records, a system designed to reduce complications during labor and delivery, and a 10,000 square-foot on-site childcare center.

This position is responsible for the development and implementation of case and utilization management programs and services. It provides leadership, direction, and support for Case Management Services to achieve quality outcomes, reduce costs, and ensure high patient, physician, and employee satisfaction. The role may also include responsibilities related to other facility-specific patient outcomes.

Essential Functions:

1. Plan, direct, and monitor case and utilization management programs. Provide advice, counsel, feedback, and coordination to foster collaboration among staff, physicians, and leadership.
2. Ensure development of case management services across the continuum supports the organization’s strategic plan. Design and implement processes for appropriate care coordination aligned with safety standards and regulations.
3. Lead multidisciplinary process improvement activities, establish performance measures, and analyze data on utilization patterns and program outcomes.
4. Manage personnel actions including recruiting, hiring, interviewing, salary decisions, training, and evaluations. Participate in setting goals and objectives for Case Management in line with company standards.
5. Oversee financial and capital resources for case management, monitor operating revenue and expenses, and develop cost control strategies. Work with external stakeholders to ensure appropriate reimbursement.
6. Develop and manage the department budget to meet organizational goals. Ensure annual budgetary targets are achieved.
7. Assess patient satisfaction; set high standards for staff and leadership to improve satisfaction scores.

Qualifications include a Bachelor’s degree in nursing or equivalent experience, RN license in the relevant state, and, if in an ambulatory setting, CCM certification within 3 years. Candidates should have at least 2 years of management experience and 2 years of direct clinical care with an appropriate patient population. Skills in problem-solving, project management, contract negotiation, conflict resolution, and communication are essential. Strong knowledge of utilization management, care management, regulatory standards, and reimbursement processes is required. Preferred qualifications include a Master’s degree in nursing or business, managed care experience, and CCM certification.

All information will be kept confidential according to EEO guidelines.

Direct Staffing Inc