Position Summary

The Nurse Manager 6 Case management provides strategic and operational leadership for inpatient care coordination, case management, and utilization management services. This role partners with physicians, hospital leadership, and system stakeholders to ensure highadquality, costadeffective, patientacentered care while optimizing throughput, length of stay, and regulatory compliance.

Key Responsibilities

• Lead Care Coordination and Case Management teams, including staff development, performance management, and engagement
• Promote evidenceadbased nursing practice, patient safety, and interdisciplinary collaboration
• Oversee utilization management processes, levela0ofacare determinations, concurrent reviews, denials management, and appeals
• Collaborate with Physician Advisors, Finance, Revenue Integrity, Patient Access, and Compliance teams
• Monitor CMS and payer compliance (IMM/MOON, authorizations, documentation standards)
• Drive patient flow initiatives to support timely admissions, transitions of care, and discharge planning
• Analyze data, trends, and outcomes to support quality improvement and financial stewardship
• Participate in hospital and systemawide committees and strategic initiatives
• Support effective use of EPIC (TogetherCare) and reporting tools

Required Qualifications

• Active Registered Nurse (RN) license in Connecticut
• BSN required; MSN or Masterads in related field preferred
• Minimum 5 years of healthcare experience, including leadership or management
• Experience in care coordination, case management, utilization management, or patient flow
• Strong communication, analytical, and changealeadership skills

Preferred Qualifications

• Masterads degree (MSN or related healthcare field)
• Experience in utilization management, denial management, and payer relations
• Prior leadership experience in a large health system or multiadepartment environment
• Knowledge of CMS regulations, payer requirements, and care management best practices