Manager - Case Management

Responsible for day-to-day oversight and coordination of case management and discharge planning functions, ensuring patient care aligns with quality standards and regulatory requirements. Requires strong clinical decision-making skills, knowledge of payer guidelines, and proficiency with Interqual or Milliman guidelines to optimize patient flow and ensure compliance. Must possess effective verbal and written communication skills, critical thinking, decisive judgment, and the ability to work independently in high-pressure environments. Key duties include monitoring performance and process improvements , working with multi-disciplinary teams , and understanding hospital information systems and regulations governing discharge planning. The role requires minimum three years of case management experience, with at least two years in leadership. Candidates should have a background in clinical decision making, medical criteria, and staff development. A nursing degree or BSN is required, with preferred certification in case management.