Director of Care Management & Social Work- 257548

Employment Type: Full-Time | Leadership

Salary: $95,000-130,000POSITION SUMMARY We are seeking an experienced healthcare executive to provide strategic direction, overall leadership, and operational oversight for our enterprise-wide Care Coordination departments, including Inpatient Care Management, Utilization Management, and Social Work. This role serves as a key operational pillar—ensuring close alignment between care coordination and nursing leadership, developing family-centered care management models, and implementing population health initiatives. The leader will oversee vendor relationships, drive transition-to-care navigation programs, improve clinical outcomes through clinical innovation, and manage utilization to support cost-effective, high-quality pediatric care.

KEY RESPONSIBILITIES: Strategic Leadership & Compliance: Partner with executive leadership to establish clinical and financial Key Performance Indicators (KPIs). Direct day-to-day operations for Case Management, Utilization Management, and Social Work to ensure full compliance with EMTALA, legal standards, and evidence-based clinical practices. Operational Oversight & Quality: Evaluate operational efficiency, establishing robust control mechanisms for hospital scheduling, insurance verifications, and financial clearances. Lead continuous quality improvement initiatives across all assigned units. Financial & Resource Management: Formulate and manage departmental operating budgets. Analyze operational and financial metrics, evaluate emerging technologies to streamline care delivery, and manage external vendor partnerships. Interdisciplinary Collaboration: Maintain active collaboration with Nursing, Managed Care, Revenue Cycle, Health Information Management (HIM), and Medical Group leadership to streamline care transitions and resolve complex cross-departmental bottlenecks. Team Development & Mentorship: Build a high-performing team by fostering professional growth, establishing clear performance expectations, and facilitating targeted education and training opportunities.

QUALIFICATIONS & REQUIREMENTS: Education

Required: Bachelor’s degree in Nursing, Social Work, Healthcare Administration, Public Health, or a related field (or an equivalent combination of education and experience).

Preferred: Master’s degree in Nursing, Management, Organizational Development, Healthcare Administration, or Social Work. Experience 10+ years of progressive experience in Case Management or Social Work.5+ years of leadership experience in an acute care hospital environment.5+ years leading cross-functional departments supporting patient/family resources, community alignment, and/or utilization management (e.g., Social Work, Financial Counseling, Case Management).Pediatric acute care experience is highly preferred. Technical Skills & Expertise

Required: Strong understanding of revenue cycle operations at the clinical/financial intersection; working knowledge of third-party reimbursement models, patient access, financial clearance, and ICD-9/ICD-10 coding; proficiency with MCG and Inter Qual criteria.

Preferred: Deep familiarity with Milliman guidelines and Allscripts Care Management (ACM).

Core Competencies: Exceptional analytical, problem-solving, and conflict-resolution skills; proven ability to influence and lead cross-functional teams; strong computer literacy. Certifications & Credentials

Required: Valid Arizona Department of Public Safety (DPS) Fingerprint Clearance Card.

Preferred: Active State of Arizona RN License (or compact state equivalent with multi-state privileges).

Preferred: National certification in Case Management (CCM), Social Work (LCSW), or equivalent credential.