Case Management Director

Description

We are seeking an experienced Case Management Director to lead and grow our case management function at a physician‑owned specialty cardiac surgical hospital with fewer than 100 beds. This is a highly visible leadership role reporting directly to the CFO and partnering closely with executive leadership and physicians. The ideal candidate brings strong utilization review and denial management expertise, executive‑level communication skills, and a positive, adaptable leadership mindset. This position is open due to internal growth and represents an opportunity to propel an established team forward while navigating regulatory change and increasing organizational sophistication. This role is 5 days onsite in Lubbock Tx.

Skills

cerner core, communciation, MCG, Sharepoint, teams, excel, Management skills

Top Skills Details

cerner core,communciation,MCG,Sharepoint,teams,excel

Additional Skills & Qualifications

Provide clinical and financial guidance to executive leadership, including presenting data‑driven insights and recommendations Partner closely with the CFO and hospital leadership on utilization review strategy, denial management, and regulatory compliance Lead, mentor, and develop a team of three case management professionals Oversee utilization review activities using MCG (Milliman) guidelines to support medical necessity and payer compliance Drive effective denial prevention and appeals strategies, identifying trends and opportunities for improvement Analyze and present utilization, length‑of‑stay, and authorization data to influence operational and financial outcomes Serve as an escalation point for complex cases, payer challenges, and cross‑functional issues Collaborate across departments and levels of the organization, including nursing leadership, physicians, finance, and revenue cycle Adapt processes and strategies in response to regulatory changes and evolving payer requirements Foster a positive, collaborative culture aligned with the hospital’s physician‑owned model Required Skills and Experience: Proven ability to communicate effectively with executives, including presenting clinical and financial information clearly and persuasively Strong data‑driven mindset with experience developing strategy informed by analytics Deep experience in utilization review and denial management Demonstrated ability to escalate, troubleshoot, and resolve complex issues through collaboration High level of emotional intelligence with the ability to work effectively across all organizational levels Positive, adaptable attitude with openness to change in a growing organization Preferred Technical Skills: Experience working with Cerner Proficiency in Microsoft Excel, SharePoint, and Microsoft Teams Strong working knowledge of MCG (Milliman) utilization review criteria

Experience Level

Expert Level

This is a Permanent position based out of Lubbock, TX.

The pay range for this position is $130000.00 - $140000.00/yr.

Will send to me once we set interview

This is a fully onsite position in Lubbock,TX.

This position is anticipated to close on Aug 17, 2026.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.