Manager Case Management

Job Description

Location : Riverside, California

Employment Type : Full-Time (Administrative Hours, Rotating Weekends)

Position Summary :

We are seeking a skilled and experienced Manager of Case Management to lead a dynamic team in a large, acute care hospital setting. This individual will be responsible for overseeing the daily operations of the case management department, ensuring compliance with regulatory standards, optimizing patient throughput, and promoting high-quality, patient-centered care. The Manager will serve as a key leader in supporting effective care coordination, discharge planning, and utilization management throughout the hospital.

Key Responsibilities :

• Provide leadership and oversight to the case management department, including Registered Nurse Case Managers and Case Management Assistants.
• Monitor departmental processes to ensure alignment with hospital policies, regulatory requirements, and professional standards.
• Foster interdisciplinary collaboration to ensure safe, efficient, and timely discharge planning and care coordination.
• Assist with patient throughput by evaluating direct admits and supporting real-time discharge planning.
• Engage in proactive discharge discussions with patients and families to set appropriate expectations and minimize delays.
• Manage staffing schedules, attendance, productivity, and daily rounding to support case management team members.
• Ensure consistent application of utilization review criteria (e.g., InterQual, MCG Guidelines) to support medical necessity and level of care determinations.
• Address delays in patient care progression, escalate barriers, and collaborate with other hospital departments to implement solutions.
• Provide ongoing staff education and hold team members accountable for process adherence and quality outcomes.
• Serve as a weekend / evening on-call resource to resolve time-sensitive case management concerns, including transportation and higher level of care (HLOC) transfers.
Qualifications :
• Education :
• Bachelor’s Degree in Nursing (BSN) – Required
• Licensure / Certification :
• Current Registered Nurse (RN) License in California – Required (Pending license may be considered)

Experience :

Department Structure :

Shift Details :

Department Culture :

The team is rooted in values of Integrity, Compassion, Accountability, and Excellence (ICARE) . The ideal candidate will be a proactive leader, skilled in communication and collaboration, who prioritizes seamless discharge planning and patient satisfaction.