Manager of Case Management
Job Description
Enterprise Solutions Inc
*Job Title:* Manager of Case Management
If your skills, experience, and qualifications match those in this job overview, do not delay your application.
*Job Type:* Full-Time
*Schedule:* Monday Friday, 8 AM 5 PM (Rotating On-Call Weekends)
*Location:* *Riverside, CA*
*About the Role:*
We are seeking an experienced and proactive *Manager of Case Management* to join our leadership team. The ideal candidate will bring a strong background in acute hospital case management and a hands-on leadership style to oversee a dynamic Case Management department.
In this role, youll lead a team of RN Case Managers and Case Management Assistants in a fast-paced acute care setting. Youll be responsible for ensuring timely and safe patient discharges, facilitating effective care coordination, and identifying and resolving barriers to patient throughput. This is a highly visible role that collaborates across departments and interacts closely with patients, families, healthcare providers, and payers.
*Key Responsibilities:*
* Provide leadership and oversight to the Case Management team, including staffing, scheduling, daily rounding, and performance management.
* Ensure compliance with regulatory standards and hospital policies.
* Promote efficient patient throughput and discharge planning, minimizing unnecessary length of stay.
* Collaborate with physicians, health plans, post-acute care providers, and internal teams to coordinate care.
* Educate staff and hold them accountable for processes related to discharge planning and care coordination.
* Escalate and resolve delays in care progression and discharge barriers.
* Monitor utilization review processes and ensure appropriate clinical documentation and compliance.
* Serve as an on-call resource for urgent issues related to patient transfers, service recovery, and transportation coordination.
*Qualifications:*
* *Education:* Bachelors Degree in Nursing (BSN) required; Masters Degree (MSN) preferred.
* *Licensure:* Current Registered Nurse (RN) license in California (or pending CA licensure).
* *Experience:*
* 35 years of case management experience in an acute hospital setting.
* Proven leadership or nursing management experience in a hospital environment.
* Strong knowledge of InterQual and Milliman criteria.
* Comprehensive understanding of reimbursement structures and payer guidelines (Medicare, Medi-Cal, Managed Care, etc.).
* Able to navigate sensitive discharge planning discussions with patients and families.
*Team Structure:*
* Reports to: Director of Case Management
* Direct Reports: RN Case Managers & Case Management Assistants (1518 FTEs)
* Supported by: Department Administrative Assistant
* Department Scope: Services all inpatient units across a 500+ bed hospital
*What We Offer:*
* Competitive Salary: *$142,771 $214,032* annually
* Relocation assistance available on a case-by-case basis
* A supportive team culture based on Integrity, Compassion, Accountability, and Excellence
* Opportunity to make a significant impact in a high-acuity, mission-driven environment
*If youre a strategic leader who thrives in a collaborative, fast-paced environment and is passionate about delivering high-quality care coordination we encourage you to apply today!*
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Job Type: Full-time
Pay: $142,771.00 – $214,032.00 per year
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Employee assistance program
* Employee discount
* Flexible schedule
* Flexible spending account
* Health insurance
* Health savings account
* Life insurance
* Paid time off
* Parental leave
* Professional development assistance
* Referral program
* Relocation assistance
* Retirement plan
* Tuition reimbursement
* Vision insurance
Schedule:
* 8 hour shift
* Day shift
* Holidays
* Monday to Friday
* On call
* Weekends as needed
Supplemental Pay:
* Bonus opportunities
* Commission pay
* Signing bonus
* Tips
Experience:
* Manager of Case Management: 3 years (Required)
* Acute care: 3 years (Required)
License/Certification:
* RN License (Required)
* Certified Case Manager (Preferred)
Ability to Commute:
* Riverside, CA 92501 (Required)
Ability to Relocate:
* Riverside, CA 92501: Relocate before starting work (Required)
Work Location: In person
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