System Director of Case Management | RN Required | Nonprofit Hospital System | Southeastern, US
System Director of Case Management | RN Required | Nonprofit Hospital System | Southeastern, US
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System Director of Case Management | RN Required | Nonprofit Hospital System | Southeastern, US
Competitive Compensation | Superb Benefits Program | Relocation Package + Temp Housing
LOCATION: Our firm, Galileo Search, is based in Marietta, GA. This position is based in the Southeastern US (Confidential Exclusive Search)
Looking to join a compassionate, patient-centered healthcare organization?
Are you passionate about making a meaningful difference in the lives of others? Our client, a regional healthcare leader, is seeking a dedicated professional to join their mission-driven team.
They’ve cultivated a culture that empowers and supports both staff and leadership—motivating everyone to bring their best selves to work each day.
Why relocate here?
Consistently ranked among the Top 25 U.S. Places for Affordable Cost of Living, our vibrant Southern city offers healthcare professionals an exceptional quality of life. Enjoy a thriving healthcare community, low housing costs, below-average taxes, and a mild four-season climate. Outside of work, explore historic landmarks, diverse cuisine, outdoor recreation, and easy access to both beaches and mountains. It’s the perfect place to grow your career and enjoy life beyond the hospital walls.
Make your best move!
For healthcare professionals seeking meaningful work, a welcoming community, and a higher standard of living without the high cost—this is the place to call home.
ABOUT THIS OUTSTANDING CAREER OPPORTUNITY
- Reports to the AVP-Case Management
- 36 FTEs across three departments
- Oversees the provision of clinical case management, discharge planning, utilization management, clinical authorizations, and appeals for all age groups within the hospital system
- Manages employee performance and promotes interdepartmental communication and education regarding case management activities and roles
- Collaborates with hospital and corporate office leadership, Case Management leadership, Medical Staff, and Administration to attain system/facility goals for the length of stay (LOS) and resource utilization while maintaining optimal patient outcomes and quality of care
- Educates staff, management, senior leadership, committee members, medical staff, and facility Advisory Boards on any action plans and compliance with CMS and State conditions of participation
- Coordinates strategic care coordination and Case Management initiatives, including reducing readmission rates, facilitating daily patient huddles, managing patient admission clearance processes, and supporting bundled payment initiatives, condition code 44, Physician Advisor program development, Clinical appeals process development, and Observation LOS management
- Develops system-wide initiatives for coordinating Case Management and Discharge Planning, working in conjunction with Community Case Management
- Searches out the best performance and best practices for Utilization Management, Discharge Planning, Inpatient and Observation Clinical Authorizations, and Case Management system-wide, including process development and targeted goals for achieving best practice results
- Works collaboratively with hospital administration, medical staff leadership, department managers, community providers, and all applicable providers to lead initiatives, create training programs, track indicators, and identify opportunities to enhance Utilization Management, Case Management, clinical authorizations, clinical appeals, throughput, and meet KPIs for length of stay, readmissions, inpatient and observation services denial reduction, and Revenue Cycle Services KPIs
EXPERIENCE | EDUCATION | LICENSURE | CERTIFICATIONS
- Bachelor's Degree in Nursing with at least 10 years of hospital-based experience as a case manager or MSW is required
- RN (Registered Nurse) required
- Accredited Case Manager (ACM) or Certified Case Manager (CCM) certification preferred
- Knowledge of community healthcare and socioeconomic resources, third-party payer authorization processes, and Joint Commission and CMS Conditions of Participation
- 10 years of supervisory/management experience in a multi-site leadership role
- Experience with Clinical Appeals, Authorizations, and LOS Management
- Knowledge of community healthcare and socioeconomic resources, third-party payer authorization processes, and Joint Commission and CMS Conditions of Participation
- Possesses excellent verbal and written communication skills and interpersonal skills
- Proven flexibility to work independently and meet/exceed deadlines, often under stressful situations
- Ability to prepare detailed, accurate, and factual reports
- Provide regular reports to staff, management, senior leadership, and various committees, including the facility Advisory Boards, on the UR Plan and compliance with all CMS and State conditions of participation
- Demonstrate problem-solving abilities, leadership, conflict management, strategic thinking, and team-building skills in order to ensure a productive work environment and achievement of goals
- Ability to establish and maintain effective working relationships with all levels of hospital staff
Ready to explore this outstanding career opportunity? Forward your resume for our immediate and confidential review TODAY!
Why Galileo Search should represent you:
20+ Years of Expertise/Experience/Specialization; Unique Insights; Front-of-The-Line Representation; Best in Industry Salary Intermediaries/Negotiators; World-Class Representation at No Cost to You; A Positive Outcome for You and Your Career - Substantially Increased
Galileo Search, LLC partners with hospitals and healthcare organizations across the United States to identify, recruit, and retain the industry's most accomplished professionals and executives. Our clients include community and critical access hospitals, health systems, academic medical centers, and Fortune 500 corporations. To learn more about Galileo Search, LLC, visit our website at www.galileosearch.com
Are you ready for an exceptional career search experience? Take the first step...
Forward your resume for confidential review or call to discuss this or other available career opportunities. Submit your resume via email for immediate consideration or use our convenient online Galileo Candidate Registry.
Galileo Search, LLC - People and Careers Perfectly Aligned.
Seniority level
Employment type
Job function
Job function
Management, Health Care Provider, and EducationIndustries
Hospitals and Health Care
Referrals increase your chances of interviewing at Galileo Search, LLC by 2x
Inferred from the description for this job
Medical insurance
Vision insurance
Paid maternity leave
401(k)
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