New

RN Director of Case Management

MedStar Health
United States, Maryland, Clinton
Oct 07, 2025
General Summary of Position MedStar Southern Maryland Hospital Center is looking for an RN Director of Case Mangement. Our hospital center is leading the way by providing the highest quality clinical care with advanced technology, innovative medical services, and the region's top doctors. Our hospital center not only treats illnesses and injuries but also promotes wellness and community health. We are a full-service acute care facility with more than 44,000 emergency room visits and nearly 11,000 admissions each year. Our hospital's commitment to advanced technology distinguishes it from community hospitals. Our goal is to help residents of Southern Maryland achieve the highest possible level of physical and mental health and thereby improve the quality of life in our community. We strive to provide comprehensive inpatient, outpatient, and community services to residents of Southern Maryland. We achievequality, safety, wellness,andpatient satisfactionthrough a spirit of patient-centered services that connect us to the community we serve. Our Heart and Vascular Center's cardiac catheterization laboratories are the site of life-saving interventions for heart attack patients, elective angioplasties, and diagnostic procedures. We have the MedStar Georgetown Cancer Institute (MGCI) at MedStar Southern Maryland Hospital Center, which has technology not available anywhere else in the area, such as Halcyon treatment system and Zap-X We have a Level II Special Care Nursery We have a strong neurosciences program, with MedStar Georgetown University Hospital neurologists and neurosurgeons available onsite. The RN Director of Case Mangement will develop, implement and evaluate the strategic plan for the hospital-wide Case Management process. Provide operational supervision of case management department. Coordinate and support ongoing problem solving. Establish tools, processes, and systems to optimize the individual roles of the department. Requirements: BSN Required, MSN Strongly Preferred Active Compact or MD RN license Required 5-7 years' experience in Case Management with 3-5 years' experience in Case Management Leadership Required 3-5 years' experience in acute care bedside nursing Required Primary Duties and Responsibilities Responsible for assuring compliance with hospital wide patient care quality monitoring in collaboration with the Performance Improvement Department. Assures performance improvement activities with ongoing monitors for the Case Management Department. Knowledgeable of the organization's performance improvement priorities and outcomes. Assists the organization to achieve compliance in the Important Functions described in the Joint Commission. Provides for direct supervision of utilization management activities as mandated by State/Federal regulations. Assures utilization criteria and monitors are approved by Medical Staff as appropriate. Maintains the program to assure coordination of patient services and financial issues related to reimbursement for care provided with all Managed Care Companies and outside providers. Assist Utilization Management Committee Chairman to prepare for meetings and comply with regulatory requirements. Assures appeals system is maintained and will coordinate with the Business Office for maximum reimbursement. A member of the Hospital Ethics Committee, the Clinical Pathways Committee, Medical Records Committee and the Performance Improvement Committee. Implements changes and maintains systems for statistical reporting of Utilization Review activities and develops outcomes documentation and reporting as the Case Management program evolves. Maintains ongoing communication with staff on the nursing units to address concerns relative to Case Management issues. Responsible for ongoing education of medical staff, nursing, and other ancillary services effected by development of and changes to the Case Management program in keeping with the changing health care environment. Assures ongoing communication with key departments/providers to assure negotiation/facilitation of patient movement through the health care system. Provides daily ongoing supervision of Case Managers and the Social Workers for case management problems direction and resolution. Plans and participates in staff development as appropriate. Responsible for personnel function of the Department including work performance and recommendations regarding personnel actions for professional and support staff. Monitors and controls departmental utilization of hospital resources and makes recommendations to the Vice President of Professional Services regarding planned budgetary departmental needs and requirements. Maintains confidentiality in accordance with hospital policy. Communicates effectively and courteously with all patients, families, visitors, physicians, and hospital staff. Minimum Qualifications Education Bachelor's degree Science in Nursing (BSN) required and Master's degree in Nursing (MSN), Healthcare Administration, Business or related field required One year of relevant education may be substituted for one year of required work experience. Experience 5-7 years Experience in utilization management, discharge planning, quality management or case management required and 3-4 years Clinical experience in an acute care setting required and Management experience required Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure in the State of Maryland or District of Columbia Upon Hire required CCM - Certified Case Manager Upon Hire preferred and Accredited Case Manager (ACM) Upon Hire preferred Knowledge, Skills, and Abilities Ability to comprehend and follow the policies and procedures for MedStar Southern Maryland Hospital Center. Ability to read, write and speak or communicate in English to successfully accomplish the essential duties of the position. Ability to demonstrate ethical behavior that supports the hospital's mission, values and commitment to compliance with all federal, state and regulatory laws. Inspires trust and exhibits honesty and integrity within the scope of daily activities. Exhibits professionalism, courtesy and excellent customer service, while interacting with patients, guests and co-workers. Ability to work effectively with people from a variety of culturally diverse backgrounds. Ability to maintain patient confidentiality. Knowledge of Joint Commission, State and Federal regulations as it pertains to Case Management. Ability to set priorities to maximize the overall effectiveness of the function and complete assignments within scheduled hours. Demonstrate initiative in acquiring knowledge to further understand the overall department and hospital functions. Ability to contribute through constructive suggestions and illustrate resourcefulness. Ability to demonstrate responsibility for work performance, consistent good attendance, and resourcefulness to solve case management problems. Knowledge and ability to use a desktop/laptop computer. This position has a hiring range of $118,331 - $230,172