MANAGER OF CASE MANAGEMENT

The Case Management Manager is responsible for the daily operational leadership of the Case Management Department, including staffing, workflow oversight, patient progression, discharge planning, staff performance, regulatory compliance, and departmental performance outcomes.

Reporting to the Director of Case Management, the Manager ensures consistent execution of case management processes. The role provides direct supervision, coaching, workflow management, clinical-operational support, and performance oversight for assigned CM staff. The Manager collaborates with physician advisors/medical directors, case management, clinical operations, revenue cycle, payer relations, quality, compliance, and other stakeholders to support timely, accurate, evidence-informed case management decisions and appropriate stewardship of healthcare resources.

MINIMUM QUALIFICATIONS

Education:

• Bachelor of Science in Nursing (BSN) required or an equivalent qualification consistent with organizational policy.
• Master's degree in Nursing, Healthcare Administration, Business Administration, Public Health, or a related field preferred.

Required length and type of experience:

• Five or more years of progressive case management/discharge planning in an acute care environment is preferred, or a closely related clinical management function.
• Prior formal leadership experience is required; two or more years of supervisory or management experience in case management is preferred.

Required licensure, certification or registry:

• Current Ohio State Board of Nursing license required.

Core Knowledge, Skills, and Competencies

• Knowledge of case management, discharge planning, and transitions of care principles.
• Understanding of Medicare, Medicaid, managed care, and commercial payer requirements.
• Knowledge of regulatory and accreditation requirements affecting case management and discharge planning.
• Demonstrated skills in people leadership, coaching, performance management, conflict resolution, and change management.
• Proficiency in operational analytics, KPI interpretation, root-cause analysis, and process improvement.
• Strong interdisciplinary communication skills, with the ability to collaborate effectively with nursing, physicians, physician advisors, payers, revenue cycle, and leadership.
• Demonstrated professional nursing judgment, ethical practice, confidentiality, and appropriate stewardship of healthcare resources.