Director Care Management - Registered Nurse or Licensed Social Worker (LMSW or LCSW)

Job Description

Job Description

Director, Care Management

Registered Nurse or Licensed Social Workers are considered for this position

Are you a strategic and experienced leader in care management? We are seeking a Director, Care Management to join our team! This full-time, day position (Monday - Friday, 9 AM - 5 PM) offers a $10,000 sign-on bonus and a competitive salary range of $130,000 - $190,000+

In this pivotal role, you'll be the central resource for our Executive Team, driving efficient, patient-centered strategies that ensure appropriate financial reimbursement. You'll have 24-hour accountability for planning and directing departments across Access, Utilization Review, Denials and Appeals, Care Coordination, Discharge Planning, Clinical Social Work, Recovery and Disease Management, and Contracting. You'll also collaborate across disciplines, with payers, and community agencies to optimize clinical outcomes within ethical, legal, and regulatory parameters.

What You'll Do:

• Lead Operations: Oversee daily operations of the Care Management Department, including hiring, education, discipline, and budget management.
• Strategic Planning: Develop department goals aligned with the hospital's mission, manage personnel, and prepare and monitor departmental budgets.
• Quality Assurance: Ensure the delivery of high-quality department and clinical services, adhering to hospital and regulatory standards.
• Team Collaboration: Work closely with interdisciplinary teams, promoting a collaborative environment within your division and across the hospital.
• Performance Improvement: Drive key departmental goals, including reducing length of stay, readmissions, and denials, while improving discharge satisfaction and transitional planning.
• Regulatory Compliance: Ensure all departmental policies are compliant with regulatory requirements.
• Mentorship: Guide and counsel Nurse Care Managers and Social Work Managers in their professional development and unit planning.
• Committee Participation: Actively participate in various hospital committees, including overseeing the Utilization Review Committee Meeting.

What You'll Bring:

• Education:
• For RNs: BSN or MSN required, or a BSN with a Masters degree in clinical or healthcare administration. CMAC (Certified as a Case Management Administrator) or CCM (Certified Case Manager) certification preferred.
• For Social Workers: Masters degree in social work, with a Licensed Social Worker (LMSW or LCSW) credential. CMAC or CCM certification preferred.
• Experience:
• At least one year of acute hospital experience.
• One year of experience in non-hospital-based healthcare (e.g., home care, insurance, outpatient).
• Previous experience managing staff or successful project implementation.
• Knowledge:
• Strong computer skills, critical thinking abilities, understanding of DRGs, Medicare Regulations, Medical Necessity Criteria, Patient Bill of Rights, and HIPAA.

If you're a results-oriented leader passionate about optimizing patient care and driving operational excellence, we encourage you to apply!