Manager Case Management

Location: Riverside, California Employment Type: Full-Time (Administrative Hours, Rotating Weekends)Position Summary:We are seeking a skilled and experienced Manager of Case Management to lead a dynamic team in a large, acute care hospital setting. This individual will be responsible for overseeing the daily operations of the case management department, ensuring compliance with regulatory standards, optimizing patient throughput, and promoting high-quality, patient-centered care. The Manager will serve as a key leader in supporting effective care coordination, discharge planning, and utilization management throughout the hospital.Key Responsibilities:Provide leadership and oversight to the case management department, including Registered Nurse Case Managers and Case Management Assistants.Monitor departmental processes to ensure alignment with hospital policies, regulatory requirements, and professional standards.Foster interdisciplinary collaboration to ensure safe, efficient, and timely discharge planning and care coordination.Assist with patient throughput by evaluating direct admits and supporting real-time discharge planning.Engage in proactive discharge discussions with patients and families to set appropriate expectations and minimize delays.Manage staffing schedules, attendance, productivity, and daily rounding to support case management team members.Ensure consistent application of utilization review criteria (e.g., InterQual, MCG Guidelines) to support medical necessity and level of care determinations.Address delays in patient care progression, escalate barriers, and collaborate with other hospital departments to implement solutions.Provide ongoing staff education and hold team members accountable for process adherence and quality outcomes.Serve as a weekend/evening on-call resource to resolve time-sensitive case management concerns, including transportation and higher level of care (HLOC) transfers.Qualifications:Education:Bachelor’s Degree in Nursing (BSN) – RequiredLicensure/Certification:Current Registered Nurse (RN) License in California – Required (Pending license may be considered)Experience:3–5 years of case management experience in an acute care hospital – RequiredPrior leadership or management experience in a clinical or case management setting – RequiredDepartment Structure:Reports to: Director of Case ManagementDirect Reports: 15–18 FTEs (including RN Case Managers & Assistants)Support: Administrative AssistantFacility Size: 540+ inpatient bedsCoverage: All inpatient unitsShift Details:Schedule: Monday – Friday, 8:00 AM – 5:00 PMOn-Call: Rotational (Evenings/Weekends) to support escalations, service recovery, transportation issues, or emergent HLOC approvals.Department Culture:The team is rooted in values of Integrity, Compassion, Accountability, and Excellence (ICARE). The ideal candidate will be a proactive leader, skilled in communication and collaboration, who prioritizes seamless discharge planning and patient satisfaction.

Created: 2025-06-04