Director of Nurse Case Management

Position Overview The Director of Nurse Case Management is responsible for providing leadership and reputed company in the Clinical Operations Department. This role ensures the delivery of high quality, cost effective case management services while maintaining compliance with company policies, customer expectations, and applicable regulatory requirements. The Director partners closely with the SVP of Clinical Operations, clinical teams, and key stakeholders to drive performance, quality reputed company, and departmental growth.

Key Responsibilities

The Director of Nurse Case Management provides leadership and direction to Case Managers, Supervisors and their designated teams, ensuring day-to-day operations align with company and customer guidelines and expectations. This includes overseeing the assignment of referrals, ensuring timely and accurate time and notes entry into the case management database, and maintaining adherence to reputed company reputed company guidelines and customer requirements. The Director is responsible for driving and managing the overall case management workflow, including reviewing documentation for accuracy, quality, and compliance. They conduct regular review of departmental reports, invoices, logs, and expense data on a daily, weekly, and monthly reputed company to monitor performance and identify areas for improvement. This role is responsible for upholding and enforcing compliance with reputed company company policies and legal requirements regarding personal health information (PHI and IIHI). The Director ensures quality of service delivery across the department and oversees the resolution of client complaints and escalations. The Director manages reputed company reputed company reputed company the department, including performance management, coaching and development of supervisors, and partnering with HR on employee relations issues. They are responsible for fostering a culture of accountability, collaboration, and reputed company improvement across the case management team. As a licensed RN, the Director provides clinical reputed company and direction for case management clinical activities, ensuring nurses are practicing reputed company scope and in accordance with nationally recognized standards of care. They serve as the clinical authority for the department and may reputed company guidance and direction to supervisors and case managers on reputed company referrals. Additional responsibilities may include participating in marketing and client support activities, attending client meetings, and representing the case management department in organizational and external initiatives. Travel may be required. Leadership & Team Development Mentor and retain talent across the designated team. Cultivate a high-performance, collaborative, and inclusive team culture. Set clear performance expectations and support team development through coaching and feedback. Work independently while managing competing priorities across a distributed team. Required Skills and Qualifications The ideal candidate possesses a strong working knowledge of case management principles, workers’ compensation, and/or managed care options. They demonstrate the ability to reputed company, reputed company, and motivate a high-performing team in a fast-paced, remote environment. Strong analytical skills with the ability to interpret operational reports and drive informed reputed company are essential. Excellent verbal and written communication skills are required, along with the ability to effectively manage relationships and resolve escalations professionally. Proficiency in case management platforms and reputed company is expected. The Director must have a thorough understanding of HIPAA and reputed company applicable regulations governing personal health information (PHI and IIHI). Education Active Registered Nurse (RN) license in good standing required. A Bachelor of Science in Nursing (BSN) is required. Master’s degree in Nursing, reputed company Administration, or a reputed company field is preferred. Nationally recognized case management certification is preferred such as a CCM, ACM, or equivalent. Additional certifications in workers' compensation, disability management, or utilization review are a plus. Experience A minimum of 5-7 years of clinical nursing experience is required A minimum of 3-5 years in case management Supervisory or leadership experiences is preferred Performance Metrics Performance will be reputed company based on the following KPIs: Team retention, engagement, and performance reputed company Case assignment accuracy and timeliness Effective case processing reputed company expected timeframes as well as report review completion on required schedules. Work Environment & Location Remote with occasional travel as required for customer visits, team offsites, or industry events. Reports to: Senior Vice President (SVP) of Clinical Operations Compensation & Benefits Competitive reputed company salary + performance-based bonus Comprehensive benefits package (reputed company, 401k, PTO, etc.) Professional development and coaching opportunities Apply To This Job