Lead Case Manager

Job Requirements

Job Summary

Supports the manager in the coordination of daily care management operations while serving as a clinical and operational expert for the team. Provides day-to-day leadership through workload coordination, staff support, onboarding, mentoring, workflow monitoring, and promotion of evidence-based case management practices. Serves as the point of escalation for complex patient situations and operational issues, helps ensure compliance with regulatory and organizational standards, and supports quality improvement initiatives. Provides guidance, coaching, and subject matter expertise to team members and collaborates closely with leadership to promote effective care coordination, operational consistency, and optimal patient outcomes.

Primary Responsibilities

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job responsibilities performed.

• Coordinates daily case management operations, including patient assignments, workload balancing, staffing coverage, and workflow prioritization to support efficient patient care delivery.
• Serves as the primary resource and escalation point for complex patient cases, care coordination challenges, and day-to-day operational issues.
• Provides guidance, coaching, and real-time consultation to case management staff regarding assessment, care planning, transitions of care, resource utilization, and regulatory requirements.
• Supports onboarding, orientation, competency development, and ongoing professional growth of case management team members through education, mentorship, and knowledge sharing.
• Monitors case management workflows, documentation practices, and required regulatory activities to promote compliance, quality, consistency, and timely completion of work.
• Conducts quality reviews, audits, and monitoring activities; provides feedback and identifies opportunities to improve care management processes, patient outcomes, and operational effectiveness.
• Reinforces evidence-based practices, professional standards, departmental policies, and standardized workflows to support high-quality care coordination services.
• Collaborates with department leadership to identify operational trends, address workflow challenges, support performance improvement initiatives, and implement process enhancements.
• Participates in recruitment, interviewing, onboarding, and retention activities by providing operational input and subject matter expertise to leadership.
• Serves as a liaison between case management staff and leadership, facilitating communication, problem resolution, and continuous improvement efforts across the department.
• Perform all other duties as assigned.

Work Experience

Education & Experience - Required

• Bachelor of Science in Nursing or Master's degree in Physical Therapy. Associate degree in Nursing or Bachelor' degree in Physical Therapy accepted if job start date prior to 2027.
• Current Maryland unrestricted licensure as a Registered Nurse (RN) or Physical Therapist (PT).
• Five (5) years of previous case management experience. Three (3) years accepted if job start date prior to 2027.
• Previous experience serving as an informal leader, preceptor, mentor, project lead, or subject matter expert with demonstrated involvement in staff development, workflow improvement, quality initiatives, or operational coordination.

Knowledge, Skills, & Abilities

• Expert knowledge of case management principles, care coordination, utilization management, discharge planning, and transitions of care.
• Expert knowledge of regulatory, accreditation, payer, and organizational requirements impacting case management practice.
• Knowledge of healthcare operations, workflow management, staffing coordination, and performance improvement methodologies.
• Knowledge of quality monitoring processes, documentation standards, and compliance expectations.
• Skills
• Skill in coordinating daily work activities, balancing workloads, and supporting efficient department operations.
• Skill in mentoring, coaching, and developing staff to enhance competency and professional growth.
• Skill in conducting audits, evaluating documentation quality, monitoring performance metrics, and providing constructive feedback.
• Skill in facilitating collaboration and communication among interdisciplinary teams, providers, patients, and caregivers.
• Skill in identifying operational challenges, analyzing trends, and implementing process improvements.
• Abilities
• Ability to serve as a clinical and operational resource for complex patient, regulatory, and workflow issues.
• Ability to provide day-to-day leadership and influence team performance without formal supervisory authority.
• Ability to assess departmental processes and recommend improvements that support quality, efficiency, and patient outcomes.
• Ability to build collaborative relationships and effectively communicate with staff, physicians, leaders, and external stakeholders.
• Ability to prioritize multiple demands, resolve problems, and support operational decision-making in a fast-paced healthcare environment

Benefits

Full-Time Days (8am-4:30pm)

Pay Range: $44.76 - $67.19/hr. (depends on years of experience)

Other Compensation (if applicable): Shift Differential

Review the 2025-2026 UMMS Benefits Guide

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