Director of Case Management
Job Description
Transform Care Coordination Into Strategic Advantage
Director of Case Management Multi-Hospital Health System
Maine
For Leaders Who See Beyond the Status Quo
Most case management leaders maintain what exists. Exceptional ones recognize where the greatest opportunities lie—in throughput, utilization, and care coordination—and have the expertise to transform those opportunities into measurable results.
A multi-hospital health system in Maine is seeking a Director of Case Management who brings both clinical credibility and operational discipline to system-wide case management leadership. This isn't about overseeing established processes. This is about assessment, stabilization, and performance improvement—with direct access to senior clinical and administrative leadership.
If you're a seasoned case management leader who thrives when the stakes are high and the challenges are real, this opportunity deserves your consideration.
Why This Role Matters
System-Level Authority and Influence
Lead case management and care coordination across multiple acute care and critical access facilities. You'll have enterprise-wide responsibility for patient flow, utilization management, discharge planning, and transitions of care—with the autonomy to drive meaningful change.
This Is a Transformation Opportunity
The organization is navigating post-acquisition transition and needs an experienced leader who can assess current operations, identify inefficiencies, and implement practical solutions that improve throughput, length of stay, and resource utilization. This is hands-on leadership with real accountability.
Your Expertise Will Drive Results
You'll use data and analytics to identify problems, remove barriers to patient flow, and implement corrective action plans. Your decisions will directly affect clinical outcomes, financial performance, and operational efficiency across the system.
Visible Leadership During Critical Phase
This role offers high visibility with senior executive leadership, nursing, physicians, and interdisciplinary teams. You'll be central to organizational stabilization efforts and positioned to shape long-term case management structure and standards.
What You'll Lead
System-Wide Case Management Operations
- Executive oversight of comprehensive case management program across multiple facilities
- Direct leadership of case managers, social workers, discharge planners, and utilization review coordinators
- Assessment and optimization of workflows, staffing models, and operational effectiveness
- Development of teams through training, mentoring, and performance management
- Creation of sustainable systems aligned with organizational goals and regulatory requirements
Throughput & Utilization Excellence
- Monitor and analyze length of stay, utilization patterns, denial rates, and throughput metrics
- Identify and address inefficiencies in patient flow and discharge delays
- Implement data-driven strategies to optimize bed utilization and reduce avoidable days
- Drive performance improvement using continuous quality improvement methodologies
- Partner with nursing and physicians to remove barriers to timely, appropriate patient progression
Care Coordination & Discharge Planning
- Design effective care coordination processes that support safe, timely transitions
- Ensure comprehensive assessment of patient needs and coordination of services
- Strengthen discharge planning practices to reduce readmissions and improve patient outcomes
- Build bridges between hospital services, post-acute care, and community resources
- Support patients and families through complex care transitions
Compliance & Quality Management
- Ensure adherence to regulatory, accreditation, and payer requirements
- Maintain expertise in Milliman Criteria, InterQual, and other utilization review standards
- Prepare for and support surveys, audits, and regulatory reviews
- Integrate quality improvement tools across case management functions
- Drive continuous improvement in clinical documentation and medical necessity practices
Strategic Partnership & Communication
- Collaborate closely with nursing leadership, medical staff, social services, and executive teams
- Serve as credible clinical and operational partner to hospital administration
- Lead teams through process changes while maintaining engagement and morale
- Use transparency and clear communication to build trust during organizational transition
- Contribute to system-wide stabilization and performance improvement initiatives
Who Excels in This Role
You Must Bring:
✓ Hospital Leadership Experience – Proven success leading case management teams in acute care settings
✓ Clinical Credentials – Active clinical licensure (RN or LCSW; specific requirements under evaluation)
✓ Case Management Expertise – Minimum 5 years of hands-on case management experience
✓ Analytical Strength – Demonstrated ability to use data for problem identification, performance evaluation, and decision-making
✓ Operational Discipline – Understanding of how utilization, LOS, and discharge planning affect both patient care and financial performance
✓ Change Leadership – Track record leading teams through operational challenges or organizational transition
What Sets You Apart:
- Case Management Certification – CCM or equivalent professional credential
- Academic Foundation – Bachelor's degree (BSN, BS, or related field)
- Utilization Review Expertise – Deep knowledge of Milliman Criteria, InterQual, and evidence-based guidelines
- Turnaround Experience – You've stabilized or rebuilt case management departments
- Complex Environment Success – You've operated effectively in resource-constrained or transitioning organizations
- Interdisciplinary Leadership – Strong ability to influence and collaborate across clinical disciplines
What This Role Requires
Hands-On Leadership
This is not a passive oversight position. You'll be directly involved in assessing operations, coaching teams, analyzing data, and implementing solutions. You need to be comfortable rolling up your sleeves.
Data-Driven Decision Making
You must be analytically strong—able to identify trends, spot inefficiencies, interpret utilization data, and translate insights into actionable improvement plans.
Clinical Credibility with Operational Acumen
You need the clinical background to earn respect from nurses, physicians, and social workers—combined with the operational discipline to drive accountability and performance.
Comfort with Complexity
You'll navigate competing priorities, incomplete information, and evolving circumstances. You must be able to lead confidently despite ambiguity and make sound decisions under pressure.
Balanced Leadership Style
You need to be firm enough to drive change, transparent enough to build trust, and collaborative enough to maintain engagement during difficult transitions.
What We Offer in Return
Compensation & Benefits
Competitive compensation package commensurate with experience Comprehensive benefits Relocation assistance available for qualified candidates Specific details shared during interview process
Professional Influence
High visibility with senior clinical and administrative leadership Direct authority over system-wide case management strategy and operations Opportunity to shape long-term organizational structure and best practices
Career Growth
Demonstrate your ability to lead complex operations through organizational change Build your reputation as a turnaround and performance improvement leader Position yourself for broader healthcare executive roles
Quality of Life
Maine offers four-season outdoor recreation, strong community connections, and a balanced lifestyle with lower cost of living than major Northeast metros—while providing meaningful professional scope and responsibility.
Candidates are encouraged to research specific communities, schools, and housing markets. Additional insights available during the interview process.
The Reality Check
This role is NOT appropriate for:
- Case management leaders without acute care hospital experience
- Those seeking a stable, maintenance-focused environment
- Leaders uncomfortable using data to drive accountability
- Individuals who prefer fully developed systems and clear roadmaps
This role IS ideal for:
- Experienced case management leaders ready for system-level responsibility
- Those who understand the connection between throughput, utilization, and financial performance
- Leaders who thrive in environments requiring assessment, stabilization, and improvement
- Professionals comfortable leading teams through change without losing credibility
- Operators who find satisfaction in solving complex problems with measurable results
Ready to Lead Transformation?
This is your opportunity to step into a role where your clinical expertise and operational leadership directly shape patient care, organizational performance, and system-wide case management excellence.
If you're an experienced case management leader who can bring structure, discipline, and clarity to complex operations—and if you thrive when leading teams through meaningful change—this role offers the authority, visibility, and executive support to make lasting contributions.