Case Management Manager

Responsibilities: The Manager of Case Management supports the strategic and daily operations of the hospital's Case Management department, including case management, social work, utilization review, and transitions of care. This role partners with hospital leadership, physicians, Revenue Cycle, and interdisciplinary teams to improve patient outcomes, optimize length of stay and readmissions, ensure regulatory compliance, and support efficient care delivery. Support daily Case Management operations and initiatives focused on length of stay, readmissions, utilization management, and transitions of care. Partner with physicians and internal and external physician advisors on utilization review, medical necessity, and appropriate level of care. Monitor and analyze key performance indicators, including length of stay and readmission data, and implement workflows to improve performance. Collaborate with Revenue Cycle and other departments on medical necessity reviews, audits, denials, and related improvement initiatives. Ensure departmental practices align with applicable federal and state regulations, standards of practice, and organizational requirements. Support Case Management staff through regular communication, education, workflow development, and training on regulatory requirements and emerging trends. Partner with the Director of Case Management to drive operational improvements and achieve hospital and organizational goals.