Manager Case Management

Job Title: Manager Case Management

Location: On-site, near Anaheim, CA

Salary Range: $140,000 - $214,000 + Relocation Assistance

Schedule: Full-Time – Admin Hours – Rotating Weekends

Company Information:

Our client is a respected hospital committed to delivering exceptional, patient-centered care in the community. They are currently seeking a full-time, permanent Manager for Case Management to join their dynamic team. This is a fantastic opportunity for a seasoned professional to lead and shape the case management department while contributing to the hospital’s overall success.

Job Summary:

We are looking for an experienced and motivated Manager Case Management to oversee and coordinate case management operations at an acute care facility. This role requires strong leadership skills and comprehensive knowledge of case management protocols and healthcare reimbursement systems.

Key Responsibilities:

• Provide leadership and direction to the case management department.
• Ensure compliance with federal and non-federal program rules and regulations regarding case management.
• Develop and implement department policies and procedures to enhance patient care and efficiency.
• Oversee staff training and development, fostering a collaborative and high-performing team.
• Review and analyze case management practices, ensuring alignment with hospital goals and industry standards.
• Maintain working knowledge of InterQual and Milliman & Robertson criteria.
• Collaborate with interdisciplinary teams to address patient needs effectively.
• Manage hospital reimbursement strategies across payers, including Medicare, Medi-Cal, Managed Care, and private insurance plans.

What Qualifications You Will Need:

• Bachelor’s Degree in Nursing (BSN) required; Master’s Degree (MSN) preferred.
• Current California Licensed Registered Nurse (RN) certification.
• Minimum of 5 years of case management experience in an acute care hospital setting or nursing management experience in such environments.
• In-depth knowledge of case management principles as defined by federal and non-federal programs.
• Proficiency in using InterQual and M&R guidelines.
• Solid understanding of hospital reimbursement mechanisms for various payer types.

Apply here today and send your resume to alex@amayastaffing.com