What are the responsibilities and job description for the Nurse Manager – Case Management position at Trinity Health MI?
Employment Type:
Full time
Shift:
Day Shift
Description:
Position purpose:
Provides clinical and operational leadership for the Case Management department, including direct management and supervision of a team of case managers. Oversees utilization review, admission, continued stay, and discharge planning processes to ensure appropriate utilization of services, quality outcomes, and cost‑effective care delivery. Collaborates with multidisciplinary teams, payers, and regulatory agencies to integrate requirements into care delivery while promoting efficient transitions of care and optimal patient outcomes.
Minimum qualifications:
Case Management Leadership and Supervision
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Full time
Shift:
Day Shift
Description:
Position purpose:
Provides clinical and operational leadership for the Case Management department, including direct management and supervision of a team of case managers. Oversees utilization review, admission, continued stay, and discharge planning processes to ensure appropriate utilization of services, quality outcomes, and cost‑effective care delivery. Collaborates with multidisciplinary teams, payers, and regulatory agencies to integrate requirements into care delivery while promoting efficient transitions of care and optimal patient outcomes.
Minimum qualifications:
- Bachelor of Science in Nursing (BSN) from an accredited school of nursing.
- Valid and current State of Michigan Registered Nurse (RN) license.
- Four years of recent clinical nursing experience
- Experience in utilization review, care coordination, or related functions
Case Management Leadership and Supervision
- Provides direct leadership and supervision to a team of case managers, including performance management, coaching, and day‑to‑day operational support.
- Assigns work, monitors workloads, and ensures appropriate coverage to meet patient care and operational needs.
- Supports onboarding, training, competency development, and ongoing professional growth of case management staff.
- Facilitates staff engagement, collaboration, and adherence to departmental policies and professional practice standards.
- Escalates staffing, performance, or workflow concerns as appropriate and partners with nursing leadership and HR to address issues.
- Oversees and performs admission, continued stay, and discharge reviews to ensure compliance with payer contracts, InterQual or equivalent criteria, and regulatory requirements.
- Reviews medical records to validate documentation supports severity of illness and intensity of services provided.
- Collaborates with physicians, nursing, social work, and interdisciplinary teams to support appropriate level of care determinations and discharge planning.
- Serves as a key liaison with payers and external case managers regarding utilization, authorization, and progression toward discharge.
- Identifies, monitors, and reports trends related to utilization, quality of care, and opportunities for improvement.
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.