Case Manager RN

Role Description The Director of Case Management is a full-time, on-site role based in Kinder, LA, responsible for overseeing the hospital’s case management functions and ensuring safe, efficient, and appropriate patient care transitions. This role leads and supervises the case management team, coordinates interdisciplinary discharge planning, and collaborates with physicians, nursing, social services, and other departments to promote continuity of care. The Director monitors utilization management activities, reviews patient status and length of stay, and supports compliance with Medicare and other payer requirements. Daily responsibilities include developing and updating case management policies, analyzing data to improve workflows, educating staff on best practices, and serving as a resource for complex medical case management issues. The role also participates in quality improvement initiatives and contributes to strategic planning related to patient flow and resource use.

Qualifications

• Strong case management foundation, including Case Management and Medical Case Management skills.
• Experience with Discharge Planning and care transition coordination across inpatient, outpatient, and post-acute settings.
• Knowledge of Utilization Management, including review processes, length-of-stay management, and resource optimization.
• Understanding of Medicare regulations and reimbursement requirements relevant to hospital-based case management.
• Licensed clinical background (e.g., RN, LCSW, or related field) with experience in acute care preferred.
• Proven leadership and team management abilities, including staff supervision, coaching, and performance improvement.
• Excellent communication, collaboration, and conflict resolution skills for working with interdisciplinary teams and external partners.
• Strong analytical and organizational skills, with the ability to interpret clinical and financial data and implement process improvements.
• Familiarity with electronic health records and case management or utilization review software.
• Bachelor’s degree in nursing, social work, or a related healthcare field required; advanced degree or certification in case management (e.g., CCM, ACM) a must