The Case Management Manager is responsible for overseeing the daily operations of a multidisciplinary care management team that supports and advances Value Based Care initiatives. This role provides leadership and operational oversight for case management, care coordination, transitional care management, emergency department follow-up, population health programs, and continuity of care activities. The Case Management Manager promotes high-quality, cost-effective patient care while driving improvements in clinical outcomes, utilization management, quality performance, and patient satisfaction. This position requires strong leadership, strategic thinking, and collaboration skills, with the ability to leverage internal and external resources to achieve organizational goals and improve healthcare delivery across the continuum of care.
Supervise and support the multidisciplinary care team, including Case Managers, Social Services staff, Emergency Department Follow-Up Coordinators, Care Coordinators, and Transitional Care Management Nurses.
Ensure effective transitions of care for patients discharged from hospitals, skilled nursing facilities, rehabilitation centers, and behavioral health facilities by coordinating:
Participate in quality improvement committees, provider meetings, hospital operational meetings, and other organizational initiatives as required.
Monitor organizational strategies and performance metrics to support clinical, operational, financial, and utilization management goals.
Build and maintain collaborative relationships with providers, community partners, hospitals, post-acute facilities, and other key stakeholders.
Travel to provider offices, care teams, and organizational sites as needed to provide education, support, and program oversight.
To perform the job successfully, an individual should demonstrate the following competencies:
Analysis and Problem Assessment
Ability to gather, analyze, and interpret data to identify trends, gaps, root causes, and opportunities for improvement.
Compassion
Demonstrates empathy, respect, and commitment to patient-centered care while maintaining confidentiality and professional standards.
Compliance
Maintains knowledge of and adheres to all organizational policies, regulatory requirements, compliance standards, and the Code of Conduct.
Communication
Communicates clearly and effectively in verbal and written formats. Demonstrates strong listening skills and adapts communication style to various audiences.
Dependability
Consistently meets deadlines, commitments, attendance expectations, and operational responsibilities while maintaining accountability for results.
Leadership and Influence
Motivates, coaches, and develops team members while promoting collaboration, accountability, and continuous improvement.
Innovation
Identifies creative solutions and opportunities to improve workflows, patient outcomes, and operational effectiveness.
Integrity
Demonstrates honesty, professionalism, ethical decision-making, and adherence to organizational values.
Judgment and Problem Solving
Makes informed, timely decisions by evaluating relevant information, identifying risks, and addressing issues proactively.
Performance Management
Establishes clear expectations, provides feedback and coaching, supports staff development, and evaluates performance effectively.
Organizational Awareness
Understands organizational priorities, operations, culture, and stakeholder relationships to achieve strategic objectives.
Patient Service Orientation
Promotes exceptional patient experiences through proactive engagement, advocacy, responsiveness, and effective problem resolution.
Planning and Organization
Prioritizes workload, allocates resources effectively, and manages multiple initiatives to achieve desired outcomes.
Results Orientation and Execution
Demonstrates accountability for achieving departmental and organizational goals while driving measurable outcomes.
Teamwork and Collaboration
Works effectively across departments and disciplines, fostering positive relationships and shared accountability for success.
Work Standards
Maintains high standards of performance and professionalism while encouraging excellence within the team.
To perform this position successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Bachelor's degree in Nursing, Healthcare Administration, Public Health, or a related field preferred.
Minimum of three to five years of clinical care management, population health, utilization management, or Value Based Care experience preferred.
Ability to effectively address sensitive inquiries from patients, providers, staff, and business partners.
Ability to identify problems, evaluate information, develop solutions, and make sound decisions in complex situations.
Proficient with Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint.
Certificates, Licenses, and Registrations
The physical demands described are representative of those required to successfully perform the essential functions of this position. Reasonable accommodations may be made for qualified individuals with disabilities.
While performing the duties of this position, the employee is regularly required to sit, stand, walk, communicate, and use hands to operate office equipment and technology. Occasional bending, reaching, stooping, and lifting of up to 10 pounds may be required. Specific vision abilities include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.
Work is primarily performed in a professional office and healthcare setting. The employee may occasionally travel between provider offices, hospitals, or other care locations. The work environment is generally moderate in noise level and may involve interaction with patients, providers, interdisciplinary teams, and community partners. The position may require flexibility in scheduling to meet operational and organizational needs.
