Top 181 Director of case management Jobs in Baltimore, Md

Director Case Management
MedStar Health —Columbia, MD
- $120,702 - $238,222 a year
- Full-time
- Nursing
- RN License
- 5 years
Senior Director, Quality Improvement
University of Maryland Medical System —Baltimore, MD
- Full-time
- RN License
- 3 years
- Master's degree
Director of Case Management
CAN —Catonsville, MD
- $80,000 a year
- Full-time
- Management
- Ability to walk for extended periods
- Office
- Health insurance
- Dental insurance
Quick Apply
19h
Hybrid Clinical Supervisor/BCBA - Federal Hill
Helping Hands Family —Baltimore, MD
- $100,000 - $115,000 a year
- Hybrid work
- Background check
- Clinic
- Supervising experience
- Continuing education credits
- Health insurance
Quick Apply
Rehabilitation Specialist/ Psychiatric Rehabilitation Program (PRP) Director-LCPC, LCSW-C
Sentinel Healthcare Inc. —Baltimore, MD
- $29 - $34 an hour
- Part-time
- Hybrid work
- Background check
- Psychiatry
- Adults
- Flexible schedule
Quick Apply
Clinical Supervisor (LCSWC or LCPC)
BTST Services —Baltimore, MD
- $75,000 - $85,000 a year
- 8 hour shift
- Hybrid work
- Experience working with individuals with disabilities
- 5 years
- Clinic experience
- Paid training
- Disability insurance
Quick Apply
10d
Director, Veteran Housing Services
ST VINCENT DE PAUL OF BALTIMORE INC —Baltimore, MD
- $70,000 - $79,000 a year
- Full-time
- Ability to lift 50 pounds
- Driver's License
- Bachelor's degree
Quick Apply
10d
Substance Abuse Counselor
Triumph Health and Wellness Center —Baltimore, MD
- $27.75 - $35.00 an hour
- Weekends as needed
- Spanish
- Addiction Medicine
- English
- Health insurance
- Dental insurance
Quick Apply
14d
Respiratory Therapist, PRN, Nights
University of Maryland Medical System —Baltimore, MD
- PRN
- CPR Certification
- BLS Certification
- Mid-level
3d
Respiratory Therapist, PRN, Nights
University of Maryland Medical System —Baltimore, MD
- $30.26 - $42.37 an hour
- PRN
- CPR Certification
- BLS Certification
- Mid-level
3d
Home Health Clinical Manager
Centerwell —Towson, MD
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Paid holidays
9d
Behavior Specialist (K-8/Fairmount Campus)
Kennedy Krieger Institute —Baltimore, MD
- $21.66 - $36.34 an hour
- Full-time
- Classroom
- Experience working with individuals with developmental disabilities
- CPR Certification
Director- Rehab Asst PTA
Powerback Rehabilitation —Columbia, MD
- $79,040 - $89,440 a year
- Full-time
- Customer service
- Physical & Rehabilitation Medicine
- Bachelor's degree
- Relocation assistance
- Health insurance
Clinical Medical Review Nurse (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $67,320 - $133,705 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- 401(k)
Quick Apply
12d
Community Services Administrator
Catholic Charities of Baltimore —Baltimore, MD
- $115,000 a year
- Weekends as needed
- Hybrid work
- Microsoft Word
- Microsoft Excel
- Microsoft Outlook
- Paid parental leave
- Paid holidays
Quick Apply
DIRECTOR, OFFICE OF ELIGIBILITY SERVICES (Program Manager Senior III)
State of Maryland - MDH Med Care Prgms - Ofc Medicaid Prgms/Operations —Baltimore, MD
- $120,722 - $156,171 a year
- Online Application
- Doctoral degree
- Office
- Master's degree
Director of Compliance
University of Maryland Medical System —Linthicum Heights, MD
- Full-time
- HIPAA
- Master's degree
- Bachelor's degree
Entitlements Case Manager 1
Enterprise Mangement Solutions Inc —Baltimore, MD
- $50,000 - $100,000 a year
- Part-time
- Psychiatry
- Adults
- HIPAA
- Disability insurance
- Health insurance
Entitlements Case Manager 6
Enterprise Mangement Solutions Inc —Baltimore, MD
- $50,000 - $100,000 a year
- Part-time
- Psychiatry
- Adults
- HIPAA
- Disability insurance
- Health insurance
Entitlements Case Manager 3
Enterprise Mangement Solutions Inc —Baltimore, MD
- $50,000 - $100,000 a year
- Part-time
- Psychiatry
- Adults
- HIPAA
- Disability insurance
- Health insurance

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Director Case Management

MedStar Health -
Columbia, MD

Apply Now

Job Details

Full-time
$120,702 - $238,222 a year

Qualifications

Cost management
Staff supervision
Case assessment
Team supervision
Managed care organization experience
Expense management
CMS
Compliance audits & assessments
ROI
Managing patients as a nurse case manager
CMS regulatory compliance
Bachelor's degree
Health insurance knowledge
Cost analysis
Utilization management
Resource utilization in healthcare
Data-driven problem-solving
Bachelor's degree in nursing
Medicaid regulations
Medicaid
Cross-functional collaboration
Clinical data analysis
Cross-functional team management
Maternal health (public health)
Data analytics technologies
Senior leadership

Full Job Description

About this Job: General Summary of Position
The Director of Case Management provides strategic and operational leadership for the health plan's enterprise case management function across two health plans under a centralized clinical operations model. The Director of Case Management (DCM) is responsible for the operational functions the Case Management team including the direct supervision coaching and counseling of staff. The DCM will direct and coordinate the Case Management operations staff with specific focus on Person Centered Enrollee Care and the Enrollee Continuum of Care models. This role designs standardizes implements and optimizes care management programs to improve quality outcomes enhance enrollee experiences reduce avoidable utilization and ensure regulatory compliance. The Director of Case Management (DCM) oversees case management activities that may include behavioral health utilization management and care management functions and serves as a liaison to government and other regulatory agencies as well as internal departments. The Director monitors staff and program performance compares results against goals recommends improvements and decisions aligning with expected outcomes. The Director supports Managers managing case management coordination and care management staff. The Director ensures adherence of case management programs across markets while addressing unique state-specific regulatory and population needs partners closely with Utilization Management Pharmacy Quality Population Health Equity and Provider Relations to drive enterprise clinical performance.

Primary Duties and Responsibilities

Leads the enterprise case management strategy across both health plans ensuring alignment with clinical quality and financial goals.
Develops and manages the field-based activities of the Case Management Assessment Team (CMAT) of RN Field Case Managers to ensure person-centered enrollee care and strict contractual compliance.
Oversees and ensures the timely execution of Case Management activities related to Enrollee Discharge Planning Transitions of Care special benefit operations (for example transportation and personal care services) Behavioral Health Case Management and Special Population Services (for example unhoused enrollees and pediatric case management).
Establishes and maintains a monitored reporting cadence (for example reports and dashboards) for enrollees in case management that include annual assessments critical incidents special populations behavioral health and transitions of care coordination efforts.
Ensures dashboard oversight for the production and validation of case management activities including standardized goals and scorecards to support contractual compliance and both individual and health plan case management performance.
Standardizes case management policies workflows and documentation practices across markets while maintaining state-specific regulatory compliance.
Monitors and improves member engagement rates including outreach success care plan completion and sustained participation. Ensure seamless integration between Case Management and Utilization Management to reduce fragmentation and duplication of effort.
Partners with Pharmacy leadership to coordinate care for members utilizing high-cost or specialty medications.
Collaborates with Quality Improvement teams to close gaps in care and improve HEDIS and other performance metrics.
Develops strategies to reduce avoidable emergency department visits and hospital readmission through proactive care coordination.
Monitors medical expense impact and total cost of care trends related to care management interventions.
Establishes and monitor key performance indicators (KPIs) including engagement rates readmission rates care plan timeliness and staff productivity while driving measurable outcomes.
Ensures compliance with state Medicaid agencies CMS NCQA and contractual requirements across both health plans deploying corrective action plans where applicable.
Supervises and develops manager and supervisors ensuring strong leadership cascade and accountability within a centralized structure.
Designs and optimizes centralized staffing models and caseload distribution to ensure efficiency and effectiveness. Establish RE's/Reasonable Expectancy targets for the assigned work.
Drives continuous process improvement initiatives using data analytics and performance insights.
Partners with Finance and Actuarial team to evaluate the ROI of care management programs.
Supports value-based payment and alternative payment models aligning case management strategies with provider performance incentives.
Provides executive-level reporting and strategic recommendations to the VP of Clinical Operations and senior leadership.
Champions a culture of member-centered culturally competent care coordination that improves health equity and outcomes across both markets.

Minimal Qualifications
Education

Bachelor's degree Nursing Social Work or related healthcare field required and
Master's degree Nursing (MSN) Public Health (MPH) Healthcare Administration (MHA) Business Administration (MBA) or related field preferred

Experience

8-10 years Progressive experience in managed care or health plan operations. required and
5-7 years Leadership experience in case management care coordination or population health management. required and
Demonstrated experience overseeing complex case management programs in Medicaid managed care strongly preferred. required and
Experience leading multi-market or centralized teams preferred. required and
Proven track record of improving quality outcomes reducing avoidable utilization and managing medical expense trends. required and
Experience with regulatory audits (state Medicaid agencies CMS) and NCQA accreditation processes. required and
Experience implementing risk stratification tools and data-driven care models. required and
Prior experience collaborating with Utilization Management Pharmacy Quality and Provider Relations functions. required

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure Active unrestricted clinical license; Multi-state licensure or eligibility for licensure in Maryland and DC.(RN strongly preferred) Upon Hire required or
LCSW- License Clinical Social Worker Multi-state licensure or eligibility for licensure in Maryland and DC Upon Hire required or
other licensed clinicians may be considered Upon Hire required and
CCM - Certified Case Manager Certified Case Manager (CCM) or other nationally recognized case management certification Upon Hire required

Knowledge Skills and Abilities

Strong knowledge of state Medicaid CMS NCQA and contractual requirements related to case management and care coordination.
Deep understanding of population health management social determinants of health and risk-based care models.
Financial acumen with the ability to interpret PMPM trends total cost of care data and ROI analysis.
Expertise in care transitions complex case management maternal health behavioral health integration and high-risk population management.
Ability to lead organization change within a centralized clinical operations model.
Strong analytical skills with the ability to translate data into actionable strategy.
Excellent executive-level communication and presentation skills.
Proven ability to build high-performing teams and drive accountability.
Skilled in cross-functional collaboration and stakeholder engagement.
Demonstrated commitment to culturally competent member-centered care.
Proficiency with care management platforms electronic health records and reporting tools.

This position has a hiring range of : USD $120,702.00 - USD $238,222.00 /Yr.

Apply Now

Refine Your Search

director of case management jobs in baltimore, md

Director Case Management

Senior Director, Quality Improvement

Director of Case Management

Hybrid Clinical Supervisor/BCBA - Federal Hill

Rehabilitation Specialist/ Psychiatric Rehabilitation Program (PRP) Director-LCPC, LCSW-C

Clinical Supervisor (LCSWC or LCPC)

Director, Veteran Housing Services

Substance Abuse Counselor

Respiratory Therapist, PRN, Nights

Respiratory Therapist, PRN, Nights

Home Health Clinical Manager

Behavior Specialist (K-8/Fairmount Campus)

Director- Rehab Asst PTA

Clinical Medical Review Nurse (Remote)

Community Services Administrator

DIRECTOR, OFFICE OF ELIGIBILITY SERVICES (Program Manager Senior III)

Director of Compliance

Entitlements Case Manager 1

Entitlements Case Manager 6

Entitlements Case Manager 3

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