RN Manager – Case Management & Utilization Management
Location: Holy Cross Health
Schedule: Full-Time
Position Purpose
Holy Cross Health is seeking a dynamic and experienced RN Manager – Case Management & Utilization Management to lead our inpatient care coordination and utilization review team. Reporting to the Director of Care Management, this role is responsible for the operational management, leadership, professional development, and quality improvement activities of the RN Case Managers. The RN Manager ensures compliance with regulatory standards and supports the mission of Trinity Health and Holy Cross Hospital.
What You Will Do
Manage daily operations of RN Case Managers and serve as a clinical resource for the team.Conduct clinical supervision and support staff development.Collaborate with physicians, physician advisors, and external review organizations to ensure quality outcomes and efficient resource utilization.Attend daily huddles, weekly interdisciplinary team meetings, and administrative meetings.Monitor and ensure compliance with incident reporting procedures and regulatory requirements.Assist with denial prevention strategies and support staff in managing medical necessity denials.Maintain positive working relationships across departments to promote patient throughput and care coordination.Minimum Qualifications
Licensure/Certification:Active Registered Nurse license in the State of Maryland required.Education:Bachelor of Science in Nursing (BSN) required; Master of Science in Nursing (MSN) preferred.Experience:Minimum of 3 years in hospital case management or related field.1–3 years of management, supervision, or leadership experience in an acute healthcare setting required.Extensive knowledge of payer mechanisms and clinical utilization management required.Preferred Qualifications:5–7 years of clinical nursing experience in an acute care setting.Experience with designation changes, utilization review, and external review organizations.Strong interpersonal skills and ability to work effectively with interdisciplinary teams.Position Highlights
Lead a high-performing team in a mission-driven healthcare organization.Play a key role in improving patient outcomes and operational efficiency.Opportunity for professional growth and leadership development.Benefits
Comprehensive benefit packages available, including medical, dental, vision, mental health, paid time off, 403B, education assistance and voluntary benefits (pet insurance, accident insurance, hospital indemnity and others) available from first day of employment.Work/Life balance with flexible schedules.Free onsite parking.Our mission and core values are what drives each member of Holy Cross Health to support each other, communicate openly and respectfully while embracing a culture that nurtures a healing, safe environment for all.Pay rate: $45.20 – $67.79
Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.
Ministry/Facility Information:
Holy Cross Health is a Catholic, not-for-profit health system that serves the two most populous counties in Maryland, Montgomery and Prince George’s, with a commitment to being the most trusted provider of health-care services in the area. Founded in 1963 by the Sisters of the Holy Cross, Holy Cross Health is a member of Trinity Health of Livonia, Michigan. Holy Cross Hospital, in Silver Spring, is one of the largest hospitals in Maryland, and Holy Cross Germantown Hospital is the first hospital in the nation built on a community college campus, enhanced by an educational partnership. The Holy Cross Health Network operates primary-care practices and affordable health centers, and offers a wide range of innovative, community-based health and wellness programs. Specialty care, home care and hospice services round out Holy Cross Health’s high-quality and coordinated continuum of care that aims to improve health and let you live life on your own terms.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, disability, veteran status, or any other status protected by federal, state, or local law.