Director Registered Nurse (RN) - Care Manager
Medical Solutions Direct Hire
Albany, GA
5x8 hrs, Days

Position Summary

We are seeking an accomplished and visionary Director of Care Management to lead the Care Management program for a major regional healthcare system in southwest Georgia. The Director will oversee all operational, strategic, and clinical components of the department, including utilization review, care coordination, transition planning, denial management, and social work functions.

This leader will set priorities and drive consistent, high-quality outcomes related to appropriate level of care, resource utilization, discharge planning, and readmission prevention. The ideal candidate is a collaborative change agent who can partner with physicians, nursing leadership, and payers to optimize both patient outcomes and organizational performance.

Key Responsibilities

• Direct the overall Care Management program, staff, and operations.
• Manage department budgeting, planning, and resource allocation.
• Ensure compliance with payer regulations and state/federal standards.
• Provide leadership in utilization review, denial management, and discharge planning.
• Partner closely with the Physician Advisor and hospital leadership on performance improvement initiatives.
• Educate teams and stakeholders on care management processes and regulatory trends.
• Foster strong relationships across clinical and non-clinical departments to support safe, efficient patient transitions.

Qualifications

Education:

• Bachelor’s degree in Nursing or Healthcare Administration (Required)
• Master’s degree in Nursing, Healthcare Administration, or related field (Preferred)

Experience:

• Minimum 4 years of acute care case management (Required)
• Minimum 5 years of progressive leadership experience, including at least 2 years at the Director level in a comparable healthcare setting (Required)

Licensure / Certifications:

• Active Registered Nurse (RN – Georgia) or Licensed Clinical Social Worker (LCSW) (Required)
• Preferred: Certified Case Manager (CCM), Accredited Case Manager (ACM), or Case Management Administrator Certified (CMAC)

Why Apply

• Join a mission-driven health system recognized for clinical excellence and community impact.
• Lead a collaborative, high-performing team that directly shapes patient outcomes.
• Competitive compensation and comprehensive benefits package.
• Professional growth opportunities within a respected regional network.