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.