Director, Case Management

Location: Brooklyn, NY, USA; office-based hospital environment

Salary: $170,000–$190,000 USD annually

Company

hirify.global provides healthcare and hospital-related services.

What you will do

• Direct case management and social work activities, monitoring quality of care, documentation, and compliance.
• Develop and evaluate utilization management, care coordination, transition management, and programs for high-risk and high-volume patients.
• Manage length-of-stay issues, concurrent utilization reviews, denials, and clinical revenue enhancement projects.
• Use data to improve department performance and achieve operational goals.
• Collaborate with department leaders to integrate Case Management and Social Work services across the continuum of care.
• Maintain regulatory readiness and update departmental policies, procedures, and staff communications.

Requirements

• Bachelor’s degree in Nursing required; a master’s degree in Nursing or related healthcare studies is preferred.
• Five to ten years of acute-care clinical experience and at least five years of case management leadership experience.
• New York State Registered Professional Nurse license required.
• Certification in Patient Review Instrument (PRI) and Screen and certification in Case Management.
• Knowledge of CMS Conditions of Participation, HIPAA, healthcare laws, regulations, privacy standards, revenue cycle, and case management systems.
• Advanced MS Word and Excel skills with strong managerial, leadership, problem-solving, and interpersonal abilities.

Nice to have

• Certification in Hospital Management.
• Master’s degree in Nursing or other health-related coursework.

Culture & Benefits

• Work in a well-lighted and ventilated hospital office setting with frequent interruptions.
• Follow hospital safety standards and strict HIPAA and information security procedures.
• Physical duties include occasional movement around the work area, office equipment operation, and light lifting of up to 15 pounds.
• Requires collaboration, stress management, dependability, integrity, and a results-oriented approach.