Manager, Inpatient Care Management

Essential Functions & Responsibilities

• Provide leadership and operational oversight of Inpatient Care Management
• Directly manage, mentor, and develop CM/SW staff, fostering strong team engagement, accountability, and professional growth.
• Oversee daily operations, including staffing schedules, timecards, PTO approval, and continuity of services.
• Monitor staff performance and competencies; develop and implement action plans to address gaps, ensure regulatory compliance, and improve efficiency.
• Lead team building, conflict resolution, and employee engagement initiatives.
• Facilitate performance improvement activities by establishing metrics, benchmarks, and performance targets.
• Collect, analyze, and report data to evaluate care management effectiveness and identify variation from standards.
• Conduct root-cause analyses of performance gaps and recommend sustainable improvements.
• Identify and communicate physician practice trends related to care management and utilization management.
• Collaborate with the Director of Inpatient Care Management Operations, Physician Advisors, and Medical Staff Leadership to develop documented improvement and education plans.
• Serve as an internal consultant and subject-matter expert for complex care management and discharge planning cases.
• Intervene with physicians as needed to resolve barriers to discharge and ensure appropriate utilization of resources.
• Support Utilization Management (UM) Committees and participate in multidisciplinary and cross-functional initiatives.
• Collaborate closely with Physician Advisors on challenging cases and throughput optimization.
• Develop, manage, and monitor operational and capital budgets for assigned programs.
• Ensure full compliance with CMS, OSHA, accrediting bodies, and established care management standards and ethical codes.
• Partner with Compliance to ensure adherence to all state and federal regulations.
• Lead orientation and ongoing competency assessments for CM/SW staff.
• Perform full human resources responsibilities, including hiring, performance evaluations, corrective actions, and employee relations.
• Maintain professional licensure, certifications, and ongoing professional development.
• Model and enforce adherence to the organization’s Code of Ethical Conduct.

Education, Experience, Licensure & Certification Requirements

• Bachelor’s Degree in Nursing (required)
• Master of Nursing Administration, Master of Health Care Administration, or related field (preferred)

• Active Registered Nurse (RN) license

• Accredited Case Manager (ACM) – American Case Management Association
• Certified Case Manager (CCM) – Commission for Case Manager Certification

• Minimum of 3 years in a relevant clinical setting
• At least 1 year of supervisory experience in a Care Management leadership role

• Strong leadership, communication, and critical-thinking skills
• Ability to prioritize, organize, and manage multiple demands independently
• Knowledge of Medicare Parts A & B, Managed Care programs, and Utilization Management requirements
• Understanding of Conditions of Participation for Discharge Planning
• Familiarity with regulatory and accreditation environments
• Proficiency with Microsoft Office applications
• Ability to travel