Manager - Case Management - Gulf Breeze

Job description

The Manager of Case Management is responsible for the daily operations, leadership, and strategic oversight of the Case Management Department. This position directs and supports case managers, social workers, utilization review staff, and other care coordination personnel in the delivery of patient-centered care across the continuum. The Manager ensures effective discharge planning, care coordination, utilization management, regulatory compliance, and resource stewardship while promoting quality outcomes, patient satisfaction, and financial performance. The Manager collaborates with physicians, nursing leaders, ancillary departments, post-acute providers, and executive leadership to facilitate safe transitions of care, optimize patient throughput, reduce avoidable delays, and achieve organizational goals. This position is responsible for staff development, performance improvement initiatives, accreditation readiness, and compliance with federal, state, payer, and organizational standards. The Manager serves as a clinical and operational resource and fosters a culture of collaboration, accountability, and continuous improvement.
• Directs, supervises, and coordinates the daily operations of the Case Management Department, ensuring the delivery of effective care coordination, discharge planning, utilization management, and transition-of-care services.
• Monitors patient progression and collaborates with interdisciplinary teams to reduce delays in care and discharge while promoting efficient utilization of hospital and community resources and supporting high-quality patient outcomes.
• Oversees compliance with CMS Conditions of Participation, accreditation standards, state regulations, payer requirements, and organizational policies.
• Monitors departmental performance indicators, including length of stay, avoidable days, readmissions, observation management, discharge timeliness, and patient satisfaction metrics.
• Leads quality improvement initiatives designed to enhance patient outcomes, operational efficiency, and regulatory compliance by accurately identifying potential problems affecting the service and implements solutions with follow through and communication.
• Collaborates with physicians, nursing leaders, finance, revenue cycle, and post-acute partners to address barriers to care and transitions.
• Ensures appropriate documentation and reporting of case management activities.
• Assists in policy development, workflow design, regulatory readiness, and survey preparation activities.
• Maintains responsibility for department’s operational excellence; ensures department delivers quality services in accordance with applicable policies, procedures, and professional standards.
• Manages team members, which includes orientation, development and evaluation of team members, and monitoring the provision of delivering quality services. Participates in the recruiting, interviewing, and selecting of team members following policies, guidelines and applicable laws. Evaluates team member’s performance relative to job goals and requirements. Provides coaching to staff, recommends education programs, and ensures adherence to internal policies and standards.
• Maintains responsibility for the fiscal management of department and assures proper utilization of organization’s financial resources.
• Effectively communicates departmental, organization, and industry information to staff.

Minimum Education
• Technical Diploma/Certificate Nursing Required or
• Associates Degree Nursing Required
• Bachelor's Degree Nursing Preferred

Minimum Work Experience
• 4 years Nursing Experience in the clinical setting ICU/PCU/MED-SURG/EMERGENCY Required or
• 3 years Critical care nursing Required
• 5 years Case management experience in the Acute Care Setting Preferred
• 4 years Broad based nursing experience Required

Licenses and Certifications
• Licensed Practical Nurse State of Florida or eligible compact state Upon Hire Required or
• Registered Nurse Licensed State of Florida or eligible compact state Upon Hire Required