Director Case Management in SOMERSET, New Jersey at RWJBarnabas Health

Job Title: Director Case Management

Location: RWJ - 379 Campus Dr,

Somerset

Department Name: Case Management

Req #: 0000262176

Status: Salaried

Shift: Day

Pay Range: $137,500.00 - $185,800.00 per year

Pay Transparency:

The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.

The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.

Director of Case Management

The Director of Case Management provides strategic and operational leadership to the Case Management Department, supporting hospital leadership in achieving high-quality, efficient patient care. This role ensures the effective integration of clinical, operational, and leadership functions to optimize patient outcomes and departmental performance.

A typical day as a Director of Case Management may look like:

• Leadership: Provide strategic leadership and oversight for Case Management operations, ensuring alignment with organizational goals and system priorities
• Foster a high-performing, engaged workforce by promoting collaboration, transparency, and a culture of continuous improvement
• Accountable for achieving system-level key performance indicator targets
• Operations: Design and optimize staffing models, workflows, and resource allocation to enhance patient care delivery and operational efficiency
• Optimizes resource utilization across the department, balancing fiscal responsibility with quality patient care
• Clinical Excellence: Establish and maintain clinical standards to ensure delivery of high-quality, patient-centered care across the continuum
• Partner with physicians and interdisciplinary teams to address complex utilization management issues and patient care escalations
• Advances equitable care delivery and integration of social drivers of health into operational strategy
• Continuous Improvement: Establish and monitor key performance indicators, holding teams accountable for achieving targets; lead performance improvement initiatives using data to drive outcomes when targets are not met
• Workforce & Professional Development: Lead, develop, and evaluate mid-level leaders and staff through performance management, coaching, and succession planning
• Promote professional development, mentoring, and leadership growth while modeling accountability, adaptability, and continuous improvement
• Oversee recruitment, selection, and retention strategies to build and sustain a strong, diverse Case Management team
• Maintains professional competence and credibility through ongoing education and engagement in industry best practices
• Regulatory & Compliance: Ensure compliance with regulatory, accreditation, and organizational standards while standardizing policies, procedures, and departmental practices
• Align with system policies, procedures, and workflows
• Communication and Collaboration: Serves as a key liaison between department, leadership, and site stakeholders to ensure alignment of goals and priorities; Builds and sustains strong relationships with physicians, nursing leadership, post-acute providers, payers, and community partners to support care coordination and system effectiveness; Represents Case Management at executive, interdisciplinary, and system-level committees, influencing decision-making and advancing strategic initiatives
• Systemness & Standardization: Advance systemness by aligning local operations with enterprise goals, collaborating with Case Management leaders across the system, and driving standardization of best practices
• Other: May perform other duties as assigned or directed by management

This role might be for you if:

• You have an advanced knowledge of healthcare systems, including expert application of medical necessity criteria, payer strategies, and denials management
• You have an expert knowledge of state and federal regulations related to case management, including utilization review, discharge planning, auditing, scope of practice, and accreditation standards; ability to operationalize regulatory requirements across the site
• You demonstrate effective communication, negotiation, and influence skills, with the ability to build and sustain effective relationships with senior leadership, physicians, payers, and external partners
• You have strong organizational and prioritization skills, with the ability to manage competing strategic priorities and lead large-scale operational initiatives
• Proven ability to lead, mentor, and develop high-performing teams and leaders, including fostering engagement, accountability, and succession planning
• You have the ability to lead change management initiatives, drive innovation, and implement improvements across multidisciplinary teams

To be considered for this opportunity, you must have:

• Master s degree in nursing, Social Work, Healthcare Administration, or related field required

• Licensure Required: Current and valid license to practice as a Registered Nurse OR Licensed Social Worker in the state of New Jersey

• Board certification in case management, CCM, ACM, or CMGT-BC, required

• Additional Licensure Preferred: CMAC, Lean Six Sigma, PMP, or other performance improvement certification preferred

• Experience Required: Minimum 8 years clinical experience in hospital, home health, or community setting.Minimum 5 years experience in acute care case management. Minimum 4 years progressive leadership experience in acute care case management