Job Description

Location: Falls Church, Virginia, United States

Salary: USD up to $3,055 weekly

Shift: 8:00 AM–4:30 PM

Position Summary

The Manager of Case Management provides operational and clinical leadership for hospital-based case management services, ensuring safe, efficient, and patient-centered care transitions. This role oversees utilization management, discharge planning, and coordination across interdisciplinary teams to support quality outcomes, regulatory compliance, and optimal resource utilization.

Key Responsibilities

• Lead, coach, and supervise case management staff, including performance management, scheduling, and professional development.
• Oversee utilization review processes to support medical necessity, level-of-care determination, and timely documentation.
• Ensure effective discharge planning and transitional planning, including coordination with post-acute providers and community resources.
• Drive outcomes management through assessment, care planning, service implementation, and ongoing evaluation.
• Collaborate with physicians, nursing, social work, and ancillary departments to remove barriers to care and reduce avoidable delays.
• Monitor key metrics (LOS, readmissions, denials, throughput) and implement process improvements.
• Ensure compliance with applicable standards, payer requirements, and hospital policies.

Required Qualifications

• BSN required.
• Current BLS required.
• Minimum of 2 years of direct supervisor/manager experience.
• Minimum of 3 years in case management or relevant nursing experience to include utilization review, discharge planning, outcomes management, transitional planning, assessment, care planning, and service implementation.
• Strong knowledge of hospital operations, interdisciplinary care coordination, and payer authorization processes.
• Excellent communication, conflict resolution, documentation, and organizational skills.
• Experience in acute care hospital case management leadership.
• Familiarity with quality improvement, data reporting, and throughput initiatives.

Work Environment

This role is based in a hospital setting and requires collaboration across multiple departments, timely decision-making, and consistent follow-through to support safe patient transitions and high-quality care.

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