VP, Case Management & Care Strategy

Med-Metrix; New York (NY); On-site; USD 180,000 - 300,000; Full time

Job summary

Med-Metrix seeks a Vice President, Case Management to lead and align case management initiatives with organizational strategy in New York. The role requires guiding utilization and transition management while ensuring HIPAA compliance and regulatory readiness across the enterprise.

The ideal candidate will possess 10+ years in acute care and case management leadership, a nursing license (NY required), and certifications in PRI/Screen and Case Management.

Qualifications

• Bachelor’s Degree in Nursing; New York State RN license.
• Master’s Degree in Nursing or related field preferred.
• Minimum of 10 years acute care clinical experience.
• Minimum of 10 years case management leadership experience.
• New York State Licensed Registered Professional Nurse.
• Certification in PRI and Screen.
• Certification in Case Management.
• Certification in Hospital Management strongly preferred.
• Broad knowledge of medical, nursing, allied health sciences, regulatory requirements, and revenue cycle.
• Proficiency in Microsoft Office Suite and case management/denials software.

Responsibilities

• Executive management of Case Management.
• Oversees Case Management and social work activities to monitor quality of care.
• Develops and implements strategy and actions plans aligned with organizational goals.
• Ensures strategies meet performance metrics and regulatory guidelines.
• Collaborates with department leaders to integrate Case Management across care continuum.
• Monitors regulatory readiness (JCAHO, federal, state).
• Maintains and revises policies for administrative and departmental case management.

Skills

Leadership

CMS knowledge

HIPAA compliance

Regulatory knowledge

Strategic planning

Education

Bachelor’s in Nursing

Master’s in Nursing (preferred)

Tools

PRI & Screen Certification

Case Management Certification

Hospital Management Certification (preferred)

MS Office

Job description

Med-Metrix seeks a Vice President, Case Management to lead and align case management initiatives with organizational strategy in New York. The role requires guiding utilization and transition management while ensuring HIPAA compliance and regulatory readiness across the enterprise.

The ideal candidate will possess 10+ years in acute care and case management leadership, a nursing license (NY required), and certifications in PRI/Screen and Case Management.