RN Nurse Manager Case Management

Nurse Manager Care Coordination & Utilization Management

The Nurse Manager Care Coordination & Utilization Management provides strategic and operational leadership for inpatient care coordination, case management, and utilization management services. This role partners with physicians, hospital leadership, and system stakeholders to ensure high-quality, cost-effective, patient-centered care while optimizing throughput, length of stay, and regulatory compliance.

Key Responsibilities

• Lead Care Coordination, Case Management, and Utilization Management teams, including staff development, performance management, and engagement
• Promote evidence-based nursing practice, patient safety, and interdisciplinary collaboration
• Oversee utilization management processes, level-of-care determinations, concurrent reviews, denials management, and appeals
• Collaborate with Physician Advisors, Finance, Revenue Integrity, Patient Access, and Compliance teams
• Monitor CMS and payer compliance (IMM/MOON, authorizations, documentation standards)
• Drive patient flow initiatives to support timely admissions, transitions of care, and discharge planning
• Analyze data, trends, and outcomes to support quality improvement and financial stewardship
• Participate in hospital and system-wide committees and strategic initiatives
• Support effective use of EPIC (TogetherCare) and reporting tools

Required Qualifications

• Active Registered Nurse (RN) license in Connecticut
• BSN required; MSN or Master's in related field preferred
• Minimum 5 years of healthcare experience, including leadership or management
• Experience in care coordination, case management, utilization management, or patient flow
• Strong communication, analytical, and change-leadership skills

Preferred Qualifications

• Master's degree (MSN or related healthcare field)
• Experience in utilization management, denial management, and payer relations
• Prior leadership experience in a large health system or multi-department environment
• Knowledge of CMS regulations, payer requirements, and care management best practices

Why Join Trinity Health of New England?

• At Trinity Health of New England, we are committed to health and healing through excellence, compassionate care, and reverence for every person. Our leaders live our mission and values every dayReverence, Commitment to Those Experiencing Poverty, Safety, Justice, Stewardship, and Integritywhile advancing care that makes a meaningful difference for our patients, families, and communities.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.