Director Case Management Hospital

Director of Case Management

Leading Faith-Based, Not-for-Profit Rural Hospital | Care Management & Swing Bed Program

Northwest New Mexico | Full-Time, Exempt | Day Shift | On-Site

COMPENSATION: $140,000 – $160,000 BASE SALARY

Plus a full benefits package — in a market where the cost of living runs roughly 22% below the national average

You went into case management to get patients to the right place at the right time. Lately the job is mostly waiting on payers: a medically ready patient holds a bed for another day while an authorization sits in someone’s queue, and the denial you prevented on the front end shows up again on the back end. And in most hospitals, the person who understands patient flow best sits three layers away from the people who decide how it is resourced — or has been told for years that a director title is “not quite yet.”

This role puts the whole continuum in your hands — utilization review, discharge planning and the hospital’s own swing-bed post-acute program — with a direct line to the CFO, a new leadership team that wants you to build, and an open door for a strong RN leader stepping into a first director seat.

THE OPPORTUNITY

Our client — a faith-based, not-for-profit Critical Access Hospital with more than a century of mission roots in the Southwest, and the only non-federal acute care provider for roughly 60 miles — is seeking a Director of Case Management to lead its Care Management department and Swing Bed Program. You will report directly to the Chief Financial Officer and lead a compact team of three direct reports, overseeing utilization review, discharge planning, care coordination and regulatory compliance for a 25-bed inpatient unit fed by a 24/7 emergency department, a hospitalist service, a family medicine residency and a network of specialty, urgent care and rehabilitation clinics. Patients come from across a wide rural region, and patients transferred to tertiary centers can return to finish their recovery close to home in the hospital’s swing beds. Because Critical Access Hospitals are paid on reasonable cost for Medicare, every utilization decision you shape shows up directly in the hospital’s financial health. You will be the architect of patient flow for an entire hospital — not one of a dozen directors waiting for a system committee to approve your ideas.

Required

• Current Registered Nurse (RN) license — New Mexico or multistate compact.
• Associate of Science degree in nursing.
• Minimum of five years of case management experience in an acute care hospital and/or managed care setting.
  
• Working knowledge of utilization management, discharge planning, payer requirements and CMS Conditions of Participation.
• Demonstrated leadership ability — team building, staff development, clear communication and responsible budgeting.

Preferred

• BSN strongly preferred; MSN welcome.
• Formal leadership experience in hospital case management (manager, supervisor or lead); first-time directors encouraged to apply.
• Critical Access Hospital, rural or swing-bed program experience.
• Case management certification (ACM-RN or CCM).
• Proficiency with InterQual or MCG criteria and hospital EHR documentation.
• Track record of reducing avoidable days, denials or readmissions in partnership with physicians and payers.

Our client is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state or local law. Reasonable accommodations are available to applicants with disabilities upon request.

For prompt and confidential consideration, please apply to the link below:

Click here to apply online