Case Management Nurse Manager Overview • The Case Management Nurse Manager oversees case management operations, ensuring compliance with regulatory standards and organizational goals. • This role includes staff supervision, performance evaluations, and the development of educational programs for continuous improvement. • Collaborates with other departments to meet organizational priorities and ensures effective communication across teams. • Manages department budgets, monitors expenses, and provides financial reports to leadership. • Serves as a resource and liaison between case management and other hospital departments. • Ensures compliance with state and federal requirements, including Medicare Conditions of Participation. • Provides direction for case management rounds and supports staff in adapting to changes. • Maintains confidentiality and protects sensitive data, including patient and personnel information. Case Management Nurse Manager Key Responsibilities & Duties • Supervise case management staff, including hiring, onboarding, and performance evaluations. • Develop and implement monthly staffing plans and coordinate daily operations. • Provide training and guidance to staff on documentation improvement and software utilization. • Collaborate with departments to meet organizational goals and regulatory requirements. • Monitor and analyze data related to case management goals and performance metrics. • Ensure compliance with Medicare Conditions of Participation and other relevant regulations. • Represent case management in hospital-wide committees and external healthcare community meetings. • Develop and manage department budgets, providing explanations for variances as needed. Case Management Nurse Manager Job Requirements • Bachelor of Science in Nursing (BSN) required; ACMA certification preferred. • Minimum of five years of RN experience and two years in case management or related areas. • Current RN licensure and Basic Life Support (BLS) certification required. • Strong knowledge of clinical processes, DRG, ICD9, and CPT codes. • Proficiency in interpreting hospital charts and regulatory criteria. • Ability to develop and implement case management processes and educational programs. • Experience in managing budgets and financial reporting. • Excellent communication and leadership skills to guide and support teams effectively.