Director of Case Management

Job description

Benefits:

n401(k)

nDental insurance

nHealth insurance

nPaid time off

nVision insurance

nDirector of Case Management

nLocation: Worcester, MA Employment Type: Full Time Work Setting: Onsite

nLead Hospital Case Management & Patient Flow

nWe are seeking an experienced Director of Case Management to lead hospital-wide Case Management operations, Utilization Management, Care Coordination, and Transition Management.

nThis leadership role is responsible for optimizing patient throughput, length of stay, medical necessity, denial prevention, reimbursement, and safe transitions of care while ensuring compliance with applicable regulatory and accreditation standards.

nWhat You'll Do

nLead the daily operations and performance of the Case Management Department

nOversee the hospital Utilization Management Plan and use data to drive performance improvement

nEnsure accurate medical necessity reviews and utilization processes in accordance with CMS requirements and organizational policies

nDrive effective patient throughput, discharge planning, and transitions of care

nSupport appropriate length of stay and initiatives focused on readmission prevention

nPartner with physicians and clinical teams to improve utilization and patient flow

nProvide education and feedback to physicians regarding hospital utilization and medical necessity

nPromote compliance with state and federal regulations and accreditation standards

nSupport denial prevention and revenue-cycle processes related to case management

nLead initiatives that improve patient experience, care coordination, and operational efficiency

nWhat We're Looking For

nRequired Qualifications

nBachelor's degree in Nursing, Business, or Healthcare Administration for RN candidates, or Master's degree in Social Work for MSW candidates

nAt least 3 years of acute hospital Case Management or healthcare leadership experience

nActive RN, LCSW, or LMSW license as applicable

nCurrent licensure/registration required to practice in the state of Massachusetts

nPreferred Qualifications

n5+ years of acute hospital Case Management leadership experience

nMulti-site Case Management leadership experience

nMaster's degree such as MSN, MBA, MHA, or MSW

nAccredited Case Manager (ACM) certification

nWhy This Opportunity?

nThis is an opportunity for a seasoned healthcare leader to make a hospital-wide impact across utilization management, patient flow, care coordination, reimbursement, and quality outcomes.

nIf you have strong acute-care Case Management leadership experience and are ready to lead strategic initiatives that improve both patient care and hospital operations, we'd like to hear from you.

n#DirectorOfCaseManagement #CaseManagement #HealthcareLeadership #HospitalLeadership #UtilizationManagement #CareManagement #PatientFlow #RNLeadership #HealthcareJobs #NursingLeadership #MassachusettsJobs #WorcesterMA

Worksite address

worcester, MA, 01609, US

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.