Director of Case Management

MissionHires is supporting a healthcare organization in southern New Mexico in hiring a Director of Case Management. This leader will oversee case management operations—spanning utilization review, discharge planning, and care coordination—to drive clinical, financial, and operational performance while ensuring patients progress efficiently through the continuum of care. The role manages a multidisciplinary team (RNs, social workers, and support staff), ensures regulatory compliance, tracks quality metrics, and partners with clinical and administrative leaders to optimize outcomes and resource utilization.

• Lead daily operations of the case management department, including staffing, workflow management, and performance oversight
• Oversee utilization review, discharge planning, and care coordination processes
• Ensure compliance with regulatory standards, accreditation requirements, and organizational policies
• Monitor quality, throughput, and efficiency metrics; identify trends and implement process improvements
• Collaborate with clinical and administrative leadership to optimize patient outcomes and resource utilization
• Develop and execute departmental goals, training programs, and performance improvement initiatives
• Manage departmental budgets and support financial objectives, including cost-effective care delivery
• Coach, mentor, and evaluate case management staff (RNs, social workers, support personnel)
• Standardize best practices, documentation, and escalation pathways across the continuum of care
• Support effective communication and interdisciplinary collaboration across units and service lines

• Active RN license in New Mexico or an eligible compact state (required)
• Minimum 3 years of experience in case management and/or utilization review (required)
• At least 2 years of leadership experience in a healthcare setting (required)
• Certification in case management (CCM or ACM) preferred
• Familiarity with InterQual or certification through a recognized healthcare quality organization preferred
• Demonstrated leadership and team management capabilities
• Expertise in care coordination, utilization review, and discharge planning
• Proven knowledge of regulatory compliance and quality improvement methodologies
• Experience with financial and operational oversight within a clinical department
• Strong communication skills and ability to collaborate across interdisciplinary teams

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