Director of Case Management (RN) at Top Tier Reps LLC – Ottumwa, Iowa

Key Responsibilities

• Provide leadership and oversight for case management, discharge planning, and social work teams
• Develop and implement strategies to ensure effective utilization review, length of stay management, and care transitions
• Monitor regulatory compliance, accreditation standards, and internal policies related to case management and discharge planning
• Collaborate with physicians, nursing, and other departments to support patient-centered care and appropriate resource utilization
• Analyze data, generate reports, and present key metrics to executive leadership
• Foster professional development and ongoing education for department staff
• Serve as a liaison between the hospital, payers, community agencies, and post-acute providers

Required Qualifications

• Bachelor's degree in Nursing, Social Work, or a related field (Master’s preferred)
• Current RN or LMSW/LCSW license in [Insert State]
• 5+ years of case management experience in an acute care setting, including at least 2 years in a leadership role
• Deep understanding of case management processes, discharge planning, and payer requirements
• Strong interpersonal, organizational, and communication skills
• Working knowledge of CMS regulations, InterQual/MCG guidelines, and EMR systems

Preferred Qualifications

• Master’s degree in Nursing, Healthcare Administration, Social Work, or a related field
• ACM (Accredited Case Manager) or CCM (Certified Case Manager) certification
• Experience managing large, multidisciplinary teams
• Familiarity with Lean, Six Sigma, or other process improvement methodologies

Salary & Benefits

• Competitive salary based on experience and qualifications
• Comprehensive benefits package, including:
  • Medical, dental, and vision coverage
  • Paid time off (PTO), holidays, and sick leave
  • 401(k) with employer match
  • Tuition reimbursement and continuing education support
  • Leadership development programs
  • Relocation assistance (if applicable)