Manager, Case Management Resume Samples

The Guide To Resume Tailoring

Guide the recruiter to the conclusion that you are the best candidate for the manager, case management job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

Craft your perfect resume by picking job responsibilities written by professional recruiters

Pick from the thousands of curated job responsibilities used by the leading companies

Tailor your resume & cover letter with wording that best fits for each job you apply

Resume Builder

Create a Resume in Minutes with Professional Resume Templates

CHOOSE THE BEST TEMPLATE - Choose from 15 Leading Templates. No need to think about design details.

USE PRE-WRITTEN BULLET POINTS - Select from thousands of pre-written bullet points.

SAVE YOUR DOCUMENTS IN PDF FILES - Instantly download in PDF format or share a custom link.

Create a Resume in Minutes

C Muller

Cyrus

Muller

43072 Jamil Passage

Detroit

+1 (555) 389 4146

43072 Jamil Passage

Detroit

Phone

p +1 (555) 389 4146

Experience Experience

Los Angeles, CA

Manager Case Management

Los Angeles, CA

Legros Group

Los Angeles, CA

Manager Case Management

The Manager of Case Management works in conjunction with other members of the interdisciplinary care team using a proactive approach to facilitate effective and efficient patient care during the hospital stay
Clinical operations across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating)
Case management and coordination of care
Takes lead role in setting direction and participating in or developing new programs
Sets team direction, resolves problems and provides guidance to members of the team
Adapts departmental plans and priorities to address business and operational challenges
Manage clinical operations across the continuum of care to include assessing, planning, implementing, coordinating, monitoring and evaluating health care delivery

Boston, MA

Manager, Case Management

Boston, MA

Bailey-Gislason

Boston, MA

Manager, Case Management

May perform case management operational activities during periods of peak workload or to support business continuity
Ensures team meets established performance metrics and performance guarantees
Directly responsible for the daily activities of the global case management team who perform ICSR case management activities
Develop, implement and maintain compliance with policies and procedures regarding medical case management
Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries
Manages the maintenance of the coding conventions and collaborates with the safety data management team to ensure safety database configurations are accurate
Performs other activities as directed by department management

present

Chicago, IL

VP, Senior Manager Case Management

Chicago, IL

Wintheiser, Bogisich and Kiehn

present

Chicago, IL

VP, Senior Manager Case Management

present

Define and implement consistent architecture and technology governance practices for BOW throughout the planning and delivery cycles. Provide both technology and architecture oversight and governance as part of this process
Lead architecture efforts that promote and implement greater architectural consistency and technology sharing across BOW
Be a key contributor to the overall technology strategy and ensuring the realization of goals such as reuse, infrastructure simplification, cost management and flexibility
Build strong cross-organizational relationships and effectively influence staff across the IT organization and broader enterprise
Define conceptual approaches and solutions architecture for BOW applications and integration among applications and services
Create conceptual and software architecture documents using industry best practices for documenting architecture. Consider both business and technical audiences
Provide cross-application subject matter expertise for BOW solutions

Education Education

Bachelor’s Degree in Nursing

Georgetown University

Bachelor’s Degree in Nursing

Skills Skills

Intermediate Ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
Intermediate Ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
Advanced Ability to effectively present information and respond to questions from peers and management
Intermediate Ability to drive multiple projects
Intermediate Ability to implement process improvements
Intermediate Ability to work in a fast paced environment with changing priorities
Intermediate Knowledge of medical terminology and/or experience with CPT and ICD-9 coding
Advanced Ability to effectively present information and respond to questions from families, members, and providers
Intermediate Ability to lead/manage others
Advanced Knowledge of healthcare delivery

Create a Resume in Minutes

15 Manager, Case Management resume templates

Read our complete resume writing guides

Manager / Case Management Resume Examples & Samples

Nursing License; RN
Bachelor’s Degree in Business, Finance, a related field or work equivalent experience with familiarity handling Medicare guidelines
At least 3 years experience in Case Management, preferable Special Needs Population and Transitions of Care
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and Access

VP, Senior Manager Case Management Resume Examples & Samples

Create an architecture strategy for BOW that furthers an integrated customer experience and promotes the development of common services and capabilities across the BOW enterprise
Define and implement consistent architecture and technology governance practices for BOW throughout the planning and delivery cycles. Provide both technology and architecture oversight and governance as part of this process
Lead architecture efforts that promote and implement greater architectural consistency and technology sharing across BOW
Understand and promote the role of architectural best practices; communicate effectively with all key constituents and actively promote the needs and benefits of governance, architecture and standards
Be a key contributor to the overall technology strategy and ensuring the realization of goals such as reuse, infrastructure simplification, cost management and flexibility
Build strong cross-organizational relationships and effectively influence staff across the IT organization and broader enterprise
Develop the architecture community within BOW and mentor architects in the development of their skills
Define conceptual approaches and solutions architecture for BOW applications and integration among applications and services
Create conceptual and software architecture documents using industry best practices for documenting architecture. Consider both business and technical audiences
Collaborate with development groups and software vendors to identify and define solutions for complex, global business requirements
Collaborate with internal partners to define application standards, conventions and best practices including compliance with security requirements
Provide cross-application subject matter expertise for BOW solutions
Participate in application capacity planning and facilitate application proof of concepts
Oversee the evaluation and selection of 3rd party software packages as well as the design of standard application configuration of these packages
Multi-task in complex, global environment while focusing on architectural success of multiple projects
Minimum of 7 years of experience as a Technology Solutions Architect
Bachelor’s degree in related information technology field
Experience with architecting and developing solutions for highly scalable, highly available systems
Experience in architecting multi-tiered solutions based on architectural best practices
Experience with service oriented architecture (SOA), Enterprise Service Bus (ESB) technology and other middleware technologies
Experience with web solution architectures
Strong strategic thinker with an ability to communicate your vision
Creative thinking and approach, essential to collaboration with BOW customers, product groups and account management to determine solutions that further the business and align with business plans and technology strategies
Outstanding analytical skills; able to critically evaluate the information gathered from multiple sources
Strong facilitation and listening skills
Ability to represent technical and business issues and solutions to multiple levels internally and externally to support strategic organizational plans
Highly effective written, verbal and presentation skills
Interpersonal skills that lend themselves to effectively negotiating priorities and resolving conflicts among project stakeholders
Excellent architecture documentation and modeling skills
Strong software development, design and application architecture skills
Significant Retail Banking experience

Manager, Case Management Resume Examples & Samples

Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes
Promote compliance with federal and state regulations and contractual agreements
Develop, implement and maintain compliance with policies and procedures regarding medical case management
Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure
Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries
Develop staff skills and competencies through training and experience

Manager, Case Management Resume Examples & Samples

Develops and implements case management workflows and policies & procedures
Partners & collaborates with other departments cross functionally regarding case management and/or Clinical Services initiatives
Directs work assignments, measures results and initiates personnel actions as required
Develops, implements and manages process improvement initiatives
Coordinates activities of unit to meet contractual company deadlines and resolves interpersonal conflicts
Proactively monitors appropriate metrics to drive up efficiency
Chairs case management committees as applicable
Maintains current knowledge of case management topics and acts as the unit’s subject matter expert (SME) on case management at department and company meetings
Required A Bachelor's Degree in Nursing or Health Administration
Required or equivalent work experience In Nursing in a clinical setting and/or MCO
Required: RN Mental Health Nurse Practitioner, RN Missouri Mental Health Clinical Nurse Specialist, or a Missouri Licensed Psychologist) –
Required 5+ years of experience in An acute clinical care setting and/or MCO related experience
Required 3+ years of experience in Case management
Advanced Knowledge of healthcare delivery
Advanced Ability to effectively present information and respond to questions from families, members, and providers
Intermediate Ability to implement process improvements
Preferred Certified Case Manager (CCM)
Required Intermediate Healthcare Management Systems (Generic) Intermediate to high level efficiency in Visio preferred
Preferred Intermediate Microsoft Visio

Manager, Case Management Resume Examples & Samples

Sets team direction, resolves problems and provides guidance to members of the team
Manage relationships with physician practices
Manage implementation of new physician practices and deployment of resources
Collaborate with cross functional teams on practice specific strategies to improve Medicare Stars ratings
Case management and coordination of care
5+ years of experience as a Registered Nurse in an outpatient setting, hospital setting, acute care, direct care experience or as a telephonic Case Manager for an insurance company
Available to travel at least 30% of the time
Case Management experience

Manager, Case Management Resume Examples & Samples

Bachelor’s degree in Nursing or equivalent experience
3+ years’ case management experience and recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience
Thorough knowledge of case and/or utilization management and clinical nursing
Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP
Previous experience as a lead in a functional area, managing cross functional teams on large scale projects
Supervisory experience including hiring, training, assigning work and managing the performance of staff
Managed Care Experience is a plus
Required - Unrestricted RN license in applicable state(s)
Case Management Certification (CCM) preferred

Manager Case Management Resume Examples & Samples

Five or more years clinical experience required, hospital setting preferred
Three to five years UM/CM experience required
One to three years charge/lead/supervisory/management experience required, in UM/CM department role preferred. Able to demonstrate leadership and management skills

Manager, Case Management Resume Examples & Samples

Ensures patient/personal safety by maintaining a safe and therapeutic environment and adhering to Safety Program and Infection Control Programs
Supports hospital and departmental Performance Improvement Goals
Demonstrates and promotes Plaza Medical Center of Fort Worth’s Mission and Values philosophies

Manager Case Management Resume Examples & Samples

Determines department staffing needs, coordinates the hiring, assignment, training and supervision of all Case Managers and Social Workers. Facilities the ongoing training and continuing education of staff and completes staff evaluation in accordance with hospital policy
Assists in developing all department/service policies and procedures, assuring compliance with all regulatory agencies. Coordinates staff education/compliance with these policies
Assists in developing the department’s goals/objectives in concert with the hospital mission, vision and values; educates staff to the goals/ objectives and provides periodic feedback as to the success in meeting these
Prepares and presents pertinent data to the Case Management committee (i.e. targeted DRG’s by LOS and cost/case, pertinent payment/resource issues, etc.)
Assists in the management of the Case Management program, which includes monitoring the appropriateness and medical necessity of admissions, continued stay and discharge planning
Maintains department employee files within the Case Management department to include but not limited to competencies, new employee orientation checklist, equipment checklist, in-service attendance, signed job description, annual feedback, and active license documentation
Education: Graduate of an accredited diploma, associates, or baccalaureate degree nursing program
Experience: Minimum of 3 years of Case Management experience
Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable)
Preferred: Case Management supervisory experience
Required: Current Texas licensure as a Registered Nurse
Preferred: Bachelors of Science

Manager, Case Management Resume Examples & Samples

License/Certification: Unrestricted RN license in applicable state(s)
3+ years case management experience and recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience
Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work
Automobile insurance

Manager Case Management Resume Examples & Samples

Takes lead role in setting direction and participating in or developing new programs
Current, unrestricted RN license in the state of Delaware
3+ years of managerial/supervisory experience
3+ years of experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
Bachelor's degree in Nursing
A background in managed care
Experience/exposure with discharge planning

Manager, Case Management Resume Examples & Samples

3+ years case management experience
Recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience
Unrestricted RN license in applicable state(s)
Valid driver's license and automobile insurance

Manager, Case Management Resume Examples & Samples

Ensures compliance to all contractual and NCQA requirements
Current, unrestricted RN license in the state of Wisconsin
3+ years managerial/supervisory experience or 5+ years of case management experience with increasing responsibility
3+ years experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
Knowledge in CMS and State regulations

Manager, Case Management Resume Examples & Samples

3+ years Case Management experience
Thorough knowledge of Case and/or Utilization Management and clinical nursing
Unrestricted RN license in Florida

Manager Case Management Resume Examples & Samples

3 + years of managerial experience or 2+ years’ of case management experience in case in acute care, home care or managed care
3+ years’ experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
Strong organizational skills and multitasking abilities

Manager, Case Management Case Management Resume Examples & Samples

Work Services employees at assigned site. This includes hospital based, clinic services, outpatient settings as well as the emergency department. Develops and sustains case management or social work policies and procedures in collaboration with other Case Management/Social Work Services site managers. Manages and participates in other policies in impacting utilization, reimbursement, patient care and safety as well as general hospital discharge planning performance. Creates and performs the annual appraisals for case managers and ED / clinic social workers and completes all progressive counseling and documentation as appropriate
Financial - Develops, recommends, and implements goals and policies for the resource management of Case Management Social Work Services, including budgeting and allocation of human resources, capital expenses, physical facilities, and supplies. Develops and maintains financial contracts with Executive Health resources utilization management support. Staffing - Recruits, develops, coaches, mentors, counsels, evaluates, and retain staff within appropriate Human Resource policies and guidelines. Maintains effective orientation / mentoring program to meet / exceed utilization and licensing guidelines. Reimbursement - In conjunction with the Medical Advisors, assures that patient stay management is appropriate to the acute care setting and resource effective
Facilitates processes to refine physician' s understanding of payer needs and alternate patient care options. Provides leadership education and decision-making on issues of use of length of stay fund and charity resources. Facilitates cost effective use of medical services and compliance with external regulations regarding discharge planning procedures, medical necessity, and allowable benefits. Oversees and manages all audits pertaining to medical necessity for denial and appealable status
Master's Degree in Social Work or graduate from accredited school of nursing
Social Work license (of LISW or LISW-S) or RN License through the State of Ohio
Minimum of five years' experience in the field of medical social work or clinical nursing care, with at least two years of management experience

Manager, Case Management, Sacramento Resume Examples & Samples

Requires a BA/BS in a health related field; 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
Current, unrestricted RN license in applicable state(s) required
Certification as a Case Manager is preferred
For URAC accredited areas the following applies: Requires a BA/BS; 5 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background
Current and active RN license required in applicable state(s)
Certification as a Case Manager from the approved list of certifications and a BS in a health or human services related field preferred
Managers who have directly supervised the case management process for three or more years must hold a certification as a case manager and meet continuing education requirements to maintain licensure and certification
Candidate must reside in the Sacramento area to meet with Hospitals, Providers and community partners

Manager, Case Management Resume Examples & Samples

Education: Bachelors of Science in Nursing (BSN or equivalent academic credit requirements for a BSN clinical education and experience required) or Social Work (BSW). Master’s degree preferred
Experience: Minimum three (3) years’ experience in utilization management, case management, discharge planning or other cost/quality management program. Three years of experience in hospital-based nursing or social work preferred
Licenses/Certifications: Current and valid license to practice as a Registered Nurse in the state of Texas OR Licensed Master Social Worker (LMSW) required, LCSW preferred. Case Manager Certification required
Knowledge of leading practice in clinical care and payor requirements
Self-motivated, proven communication skills, assertive
Background in business planning, and targeted outcomes
Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management
Working knowledge of the concepts associated with Performance Improvement
Demonstrated effective working relationship with physicians
Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes
Assists in supervising and managing all aspects of the local level program
Supports growth and development of the case management program consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities as needed
Responsible for coordinating day to day operations of the program at the unit level
Assists in identifying and achieving optimal targeted financial outcomes via the inpatient case management process
Participates in departmental personnel functions (hiring, firing, etc.) in conjunction with the Director of Case Management
Provides input to annual and interim performance appraisal reviews for the professional and non-professional staff in department
Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospitalists, community care managers, nurses, community resources, etc.)
Responsible for leading a high performance team of “system thinkers” who incorporate leadership principles and vision in performing the functions of case management
Uses data to drive decisions, plan, and implement performance improvement strategies for case management
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service

Manager Case Management Resume Examples & Samples

Manage clinical operations across the continuum of care to include assessing, planning, implementing, coordinating, monitoring and evaluating health care delivery
Set team direction, resolve problems and provide guidance to members of the team to ensure they meet the established performance metrics and goals
Take a lead role in developing and participating in new program initiatives and innovations
Provide monitoring and oversight of care management and coordination of care for our members
Serve as a coach, mentor and advocate for staff in their development and training
Adhere to ethical, legal/regulatory and accreditation standards to meet business goals and objectives
Create an environment that supports change and models accountability for staff
Track and report performance metrics and identify opportunities for continuous improvement
Conduct team meetings, field-based shadowing of team members, caseload auditing, and implement performance improvement plans
Understand and use data to manage the team as well as individual performance
Current, unrestricted RN license in the state of New Jersey
Minimum of 5 years care management/care coordination experience within a medical, corporate or behavioral healthcare setting
5+ years of Clinical background required
3 years previous leadership experience with direct reports, with the ability to partner with staff to build high-performing teams
Excellent organization, communication, teambuilding, and time management skill
Ability to proactively partner with care team, including primary care, behavioral health, state partners, and other key stakeholders
Strong problem solving and decision making abilities
Proficiency in MS Word and MS Excel, to include the ability to create documents and spreadsheets
Certified Care Manager (CCM)

Manager Case Management Resume Examples & Samples

MSW, LCSW, or RN (Arizona State License required)
Accredited Case Manager (ACM) preferred
Minimum of two years acute hospital experience preferred
Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computer literacy

Manager, Case Management Resume Examples & Samples

Minimum 3+ years of experience in a hospital setting, acute care, direct care experience OR experience as a telephonic Case Manager for an insurance company
Solid computer proficiency with basic level of experience with Microsoft Word and with the ability to navigate a Windows environment
Working knowledge of Medicare and Medicaid
Must have a reliable vehicle, a current and unrestricted driver's license and proof of insurance
Minimum of 3+ years of experience as a manager
Experience in home health or hospice
CBA experience (community based alternatives)

Manager Case Management Resume Examples & Samples

Conduct team meetings, field - based shadowing of team members, caseload auditing, and implement performance improvement plans
Minimum of 5 years care management / care coordination experience within a medical, corporate or behavioral healthcare setting
Previous leadership experience with the ability to partner with staff to build high-performing teams

Case Manager / Case Management / Days Resume Examples & Samples

Creates plan for care across the continuum, integrating patient/family preferences and values
Monitors patient care through assessments, evaluations and/or patient records
Certified BLS Provider specializing in Basic Life Support credentialed from the American Heart Association (AHA) obtained within 1 Month (30 days) of hire date or job transfer date
Licensed Clinical Registered Nurse credentialed from the Texas Board of Nursing
3 years of nursing experience required. 5 years preferred

Manager, Case Management Resume Examples & Samples

Oversee the workflow and day-to-day operations of the case management function
Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes for case management
Ensure compliance with federal and state regulations and contractual agreements
Develop, implement and maintain compliance with policies and procedures regarding medical and social case management
Develop, implement, and maintain case management programs to facilitate the use of appropriate medical and community resources and decrease health plan financial exposure
Ensure proper coordination and communication of medical service functions with other departmental functions at the business as assigned
Assist with provision of Medicare coverage and services

Manager Case Management Resume Examples & Samples

ADA Essential Functions
Bachelor’s Degree in Nursing, required. Master’s Degree, preferred
Current license to practice as a Registered Professional Nurse in New York State
Certified Case Manager (CCM), Nurse Case Manager (RN, CM), Case Manager, Certified (CMC) or Certified Professional in Health Care Quality (CPHCQ), preferred
Minimum of five (5) years administrative/supervisory case management experience in an acute care environment, required

Manager, Case Management Resume Examples & Samples

Provides coaching and mentoring to staff on a daily basis
Completes relevant HR activities such as timeoff requests, job description review, performance management activities ensuring all employees have clear goals, objectives and development plans, performance review discussions, etc
Ensures team execution of case management activities ensuring that the submissions and reconciliation team can submit cases to regulatory authorities and business partners’ ontime
May perform case management operational activities during periods of peak workload or to support business continuity
Directly responsible for the daily activities of the global case management team who perform ICSR case management activities
Manages team/personnel in daily activities include overseeing performance management, staff development plans and execution of those plans; coaching and mentoring staff to deliver high quality while meeting regulatory timelines
Recruits and facilitates the onboarding of staff, collaborating with Learning and Development to ensure appropriate training is assigned
Identifies product leads and backup product leads to ensure business continuity
Identifies resource needs and allocations to ensure appropriate function of the team
Manages daily workload for the team to ensure timely completion of data entry, triage, E2B acceptance (and failures) and case processing, ensuring that submission and reconciliation can achieve a high level of reporting compliance to health authorities and business partners
Closely collaborates with the Global Case Management Leader, Vendor
Management team, and the Submissions & Reconciliation team to ensure high quality and compliance of case management activities across internal teams and the case management vendor
Collaborates with medical reviewers to ensure that medical review and documentation is provided for assigned cases
Collaborates with the Agreements and Compliance team to support the investigation of root cause for late individual case safety reports, including implementing corrective and preventive actions, if appropriate
Manages the maintenance of the coding conventions and collaborates with the safety data management team to ensure safety database configurations are accurate
Participates in the review of regulatory intelligence to identify any changes to case management activities. As appropriate collaborates with the process, SOP and training team to make necessary internal procedural changes
Acts as a liaison with internal departments and external business partners on case management issues
Performs other activities as directed by department management
BS/BA degree in a health related (e.g., RN/BSN, RPh/PharmD) or biological science related field or a combination of nondegree education and 10+ years of industry experience 8+ years PV, regulatory or compliance related experience
Minimum 1+ years people management (direct reports) experience or 2+ years of leading project teams (no formal direct reports but responsible for team deliverables)