JOB SUMMARY

A prominent acute care hospital in Northern New Jersey is seeking a dynamic and experienced Director of Case Management. This senior leader will develop and implement our continuum of care services, overseeing all case management, utilization review, and social work functions. The ideal candidate will be a strategic leader focused on delivering superior clinical, financial, and operational outcomes by improving care coordination, managing length of stay, and reducing readmissions.
This position requires close collaboration across multiple disciplines and offers a significant opportunity to impact patient care and hospital performance.

• Lead, mentor, and manage the daily activities of the Case Management and Social Work teams, including recruitment, supervision, and performance evaluation.
• Direct and optimize utilization management, discharge planning, and care coordination processes to ensure patients move seamlessly through the care continuum.
• Collaborate with physicians, nursing leaders, and administration to ensure appropriate patient admissions, manage length of stay against benchmarks, and facilitate safe, efficient discharges.
• Drive performance improvement by tracking, analyzing, and reporting on key metrics such as Length of Stay (LOS), readmission rates, avoidable days, and payer data.
• Ensure departmental compliance with all external regulatory bodies and auditing requirements; maintain an expert knowledge base of current regulations.
• Provide education and guidance to physicians and staff on medical necessity, patient status (inpatient vs. observation), and clinical documentation.
• Develop and manage the departmental budget and contribute to the hospital’s long-range strategic planning activities.
• Act as a key liaison between the acute care setting and post-acute services (e.g., SNFs), ensuring smooth care transitions for patients.
• Support the organization’s patient satisfaction goals and the pursuit of Magnet recognition for nursing excellence.