Director Case Management Hospital

CAREER OPPORTUNITY

Director of Case Management

Leading Faith-Based, Not-for-Profit Rural Hospital | Care Management & Swing Bed Program

Northwest New Mexico | Full-Time, Exempt | Day Shift | On-Site

COMPENSATION: $140,000 – $160,000 ANNUALLY + RELOCATION ASSISTANCE

Plus a full benefits package — in a market where the cost of living runs roughly 22% below the national average

You went into case management to get patients to the right place at the right time. Lately the job is mostly waiting on payers: a medically ready patient holds a bed for another day while an authorization sits in someone’s queue, and the denial you prevented on the front end shows up again on the back end. And in most hospitals, the person who understands patient flow best sits three layers away from the people who decide how it is resourced — or has been told for years that a director title is “not quite yet.”

This role puts the whole continuum in your hands — utilization review, discharge planning and the hospital’s own swing-bed post-acute program — with a direct line to the CFO, a new leadership team that wants you to build, and an open door for a strong RN leader stepping into a first director seat.

Our client — a faith-based, not-for-profit Critical Access Hospital with more than a century of mission roots in the Southwest, and the only non-federal acute care provider for roughly 60 miles — is seeking a Director of Case Management to lead its Care Management department and Swing Bed Program. You will report directly to the Chief Financial Officer and lead a compact team of three direct reports, overseeing utilization review, discharge planning, care coordination and regulatory compliance for a 25-bed inpatient unit fed by a 24/7 emergency department, a hospitalist service, a family medicine residency and a network of specialty, urgent care and rehabilitation clinics. Patients come from across a wide rural region, and patients transferred to tertiary centers can return to finish their recovery close to home in the hospital’s swing beds. Because Critical Access Hospitals are paid on reasonable cost for Medicare, every utilization decision you shape shows up directly in the hospital’s financial health. You will be the architect of patient flow for an entire hospital — not one of a dozen directors waiting for a system committee to approve your ideas.

• Genuine Autonomy — You own the department and the swing-bed program end to end: the UR process, the discharge model, the payer escalation pathway and the metrics. With a direct line to the CFO and a small executive team, a good idea becomes a new workflow in weeks, not quarters.
• Meaningful Work With Real Leverage — Swing beds let rural patients recover near family instead of in a facility hours away — and research on Critical Access Hospitals finds swing-bed revenue exceeds 20% of total inpatient revenue at more than a third of hospitals studied. Building this program is mission work and margin work at the same time.
• Collaboration, Not Isolation — You will know the hospitalists, the emergency physicians, the residents and the CFO by name. Case management sits at the table where patient flow, payer strategy and the cost report are actually discussed — not in a back office absorbing the fallout.
• A Real Step Up — The client will seriously consider an accomplished case management manager, supervisor or lead ready for a first director role. New Mexico is a Nurse Licensure Compact state, which keeps the license transition straightforward for RNs relocating from other compact states.
• A Schedule Built for a Human Being — Full-time, day-shift leadership in a community where the average commute is under 20 minutes. Paid time off, New Mexico paid sick leave and an on-site employee fitness center are part of the package, not afterthoughts.
• An Organization That Is Growing — A new executive leadership team, stable financials, improving staff retention and steady reinvestment: reopened operating rooms, 3D mammography, renovated imaging and full laboratory accreditation from the College of American Pathologists. Relocation assistance and tuition reimbursement come with the offer.

• Lead the Care Management department — direct staff and fiscal resources, recruit and develop the team, and build a culture of accountability, compassion and follow-through.
• Build and grow the Swing Bed Program — own admission criteria, education, referral outreach and compliance, and position the program as the region’s first choice for post-acute recovery close to home.
• Own utilization review and medical necessity — apply payer criteria and CMS Conditions of Participation, manage authorizations and escalations, and partner with physicians so status and level-of-care decisions hold up.
• Drive throughput and transitions of care — design discharge planning that starts at admission, removes avoidable days, and connects patients to home health, community and post-acute resources across a wide rural service area.
• Protect revenue and survey readiness — monitor denials and appeals, prepare for recovery audits and accreditation surveys, and keep documentation strong enough to withstand scrutiny.
• Turn data into decisions — develop the statistics that demonstrate resource-appropriate use of hospital resources and report results to the CFO and executive team.
• Step in where it counts — perform case management directly when the team needs coverage, leading by example.

Required

• Current Registered Nurse (RN) license — New Mexico or multistate compact.
• Associate of Science degree in nursing.
• Minimum of five years of case management experience in an acute care hospital and/or managed care setting.
• Working knowledge of utilization management, discharge planning, payer requirements and CMS Conditions of Participation.
• Demonstrated leadership ability — team building, staff development, clear communication and responsible budgeting.

Preferred

• BSN strongly preferred; MSN welcome.
• Formal leadership experience in hospital case management (manager, supervisor or lead); first-time directors encouraged to apply.
• Critical Access Hospital, rural or swing-bed program experience.
• Case management certification (ACM-RN or CCM).
• Proficiency with InterQual or MCG criteria and hospital EHR documentation.
• Track record of reducing avoidable days, denials or readmissions in partnership with physicians and payers.

Compensation

• $140,000 – $160,000 annually, positioned by experience, plus relocation assistance to help you make the move.
• A cost of living roughly 22% below the U.S. average and median home prices near $241,000 — a director salary that goes considerably further here than in a metro market.

Health & Wellness

• Blue Cross Blue Shield medical coverage, plus dental and vision plans.
• Employee Assistance Program, an employee wellness program and an on-site employee fitness center.
• Voluntary accident and critical illness coverage.

Financial Security

• 403(b) retirement plan.
• Basic life insurance plus voluntary life, short- and long-term disability, and a flexible spending account.

Growth & Development

• Tuition reimbursement toward a BSN, MSN or case management certification.
• A teaching environment anchored by a family medicine residency, and a seat close to executive decision-making that builds the résumé for CNO, VP and system-level care management roles.

Work-Life Balance

• Paid time off and New Mexico paid sick leave, plus FMLA protection and bereavement leave.
• Corporate discounts, an employee referral program and casual Fridays.

Our client is a faith-based, not-for-profit 501(c)(3) health care system whose roots reach back to mission hospitals founded in the early twentieth century, later joined together so an entire region could keep reliable care close to home. The mission is explicit and it shapes daily decisions: make a lasting difference in the health and quality of life of everyone in the community.

Today the organization is anchored by a 25-bed Critical Access Hospital with a 24/7 emergency department, medical-surgical and advanced-care beds, surgery, imaging, laboratory, cardiology, orthopedics, nephrology, pediatrics, behavioral health and addiction medicine, supported by a specialty clinic, an urgent care center, a family medicine practice and a wellness and rehabilitation center. It is the only non-federal acute care provider within roughly 60 miles — the hospital an entire region counts on.

It is also an organization on a clear upward path. Under a new executive leadership team, it is operating on stable financial footing, retention is improving, and services are growing. It earned Critical Access designation and independent CAH accreditation, launched its swing-bed program, reopened its operating rooms, added 3D mammography, renovated radiology and earned College of American Pathologists laboratory accreditation. The next chapter of that growth runs through case management — which is exactly why this seat matters.

The role is based in a high-desert city of about 21,000 on the historic Route 66 and I-40 corridor of Northwest New Mexico, at roughly 6,500 feet. The cost of living runs about 22% below the national average, commutes are short, and the region averages around 255 sunny days a year. Red sandstone cliffs start at the edge of town: more than 25 miles of urban hiking and biking trail, another 186 miles of mountain trail within a 15-minute drive, rock climbing and one of the most photographed hot-air balloon rallies in the state. The Native American heritage of the Four Corners region runs through the arts, food and festivals of everyday life; Albuquerque and its international airport are about two hours east, and the canyon country and national parks of the Southwest are a weekend drive away. It is a place for people who want their work to matter and their weekends outdoors.

READY TO MAKE YOUR NEXT MOVE?

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Client identity and full application details will be shared with qualified, vetted candidates.

Our client is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state or local law. Reasonable accommodations are available to applicants with disabilities upon request.