Social Services Director of Care Management

Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more We are seeking a capable Director, Care Management who has acquired broad experience in caring for patients and has developed a sound understanding about the care of a particular patient population.Provides oversight, direction, and strategy for Care Management within the Emory Healthcare system.Responsible for the day-to-day operations for all case management activities at the local hospital, including utilization management, transitions of care, discharge planning, payer authorization, medical necessity, and status designation.Provides clinical leadership for all CM programs by serving as an educator, role model, advocate, and change agent to enhance patient care and staff competency.Lead local efforts and actively participate in system efforts to optimize care coordination across the continuum and ensure efficient resource utilization, quality outcomes, and maximize reimbursement.Responsible for all departmental performance metrics, cost effectiveness, ongoing quality, productivity and overall efficiency for the Care Management Department.Collaborate with the executive team, physicians, various leaders and staff to ensure barriers to case management performance metrics such as length of stay (LOS), avoidable days, readmissions, payer denials and other case management related outcomes are addressed timely with focus on identifying and driving performance improvement initiatives.Manage, interpret, and share data in a meaningful and actionable way.Collaborate with system Care Management leaders in order to create and/or enhance/maintain case management systems and standard workflows in an effort to reduce financial risk to the patient and hospital, maximize reimbursement, and ensure compliance with regulatory and compliance requirements.MINIMUM QUALIFICATIONS:Must have a Bachelor's degree in Nursing or related field.Master's degree in Nursing preferred.Master's degree in Social Work with licensure accepted in lieu of Nursing requirements.Must have experience in an acute care hospital setting with at least 7 years in care management or comparable experience.Must have at least 3 years leadership experience.ACM or CCM certification preferred.JOIN OUR TEAM TODAY! Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet® designated ambulatory practice. We are made up of 11 hospitals-4 Magnet® designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.

Created: 2025-06-06