This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director of Nurse Case Management based in the United States.
Lead a high-performing clinical operations team dedicated to delivering exceptional case management services while driving quality, compliance, and operational excellence. In this strategic leadership role, you'll oversee multidisciplinary teams, optimize workflows, and ensure outstanding patient and client outcomes in a remote-first environment. Working closely with senior leadership and cross-functional stakeholders, you'll shape clinical processes, mentor future leaders, and foster a culture of accountability and continuous improvement. This opportunity is ideal for an experienced registered nurse with a passion for leadership, clinical excellence, and building scalable healthcare operations that make a meaningful impact.
Accountabilities:
- Provide strategic leadership and day-to-day oversight of nurse case managers, supervisors, and clinical teams to ensure efficient, high-quality service delivery.
- Direct case management operations, including referral assignments, documentation quality, workflow management, and timely completion of clinical activities.
- Monitor operational performance through regular analysis of reports, productivity metrics, invoices, expenses, and departmental data to identify improvement opportunities.
- Ensure compliance with HIPAA, PHI/IIHI regulations, organizational policies, customer requirements, and industry standards across all clinical operations.
- Serve as the senior clinical authority by providing guidance on complex case management situations and ensuring clinical practices align with recognized standards of care.
- Lead performance management initiatives, coach supervisors, support employee development, and partner with Human Resources on employee relations matters.
- Foster a collaborative, high-performing team culture focused on accountability, engagement, retention, and continuous improvement.
- Manage client escalations, maintain strong stakeholder relationships, and support customer meetings, business development initiatives, and organizational representation when needed.
- Participate in strategic initiatives and travel occasionally for client visits, team events, or industry-related activities.
Requirements
- Active Registered Nurse (RN) license in good standing is required.
- Bachelor of Science in Nursing (BSN) is required; a Master's degree in Nursing, Healthcare Administration, or a related field is preferred.
- Minimum of 5–7 years of clinical nursing experience and at least 3–5 years of case management experience.
- Previous leadership or supervisory experience within clinical operations or case management is preferred.
- Strong knowledge of case management principles, workers' compensation, managed care, and healthcare delivery models.
- Thorough understanding of HIPAA regulations and requirements governing Protected Health Information (PHI) and Individually Identifiable Health Information (IIHI).
- Strong analytical skills with experience interpreting operational metrics, performance reports, and quality indicators to drive informed decision-making.
- Excellent leadership, coaching, communication, conflict resolution, and relationship management skills.
- Proficiency with case management systems, Microsoft Office applications, and healthcare technology platforms.
- Professional certifications such as CCM, ACM, or equivalent are preferred. Additional certifications in workers' compensation, disability management, or utilization review are considered an asset.
- Ability to work independently, manage multiple priorities, and lead distributed teams in a remote environment.
Benefits
- Competitive base salary.
- Performance-based bonus opportunity.
- Comprehensive healthcare benefits package.
- 401(k) retirement savings plan.
- Paid time off and holiday benefits.
- Professional development, leadership coaching, and career growth opportunities.
- Fully remote work environment with flexibility.
- Opportunity to lead a growing clinical operations function with meaningful organizational impact.
- Occasional travel for client meetings, team gatherings, and industry events.