[Remote] Director of Nurse Case Management

Note: The job is a remote job and is open to candidates in USA. Opus Medical is seeking a Director of Nurse Case Management to provide leadership and oversight in the Clinical Operations Department. This role is responsible for delivering high quality, cost effective case management services while ensuring compliance with company policies and regulatory requirements.

Responsibilities

• The Director of Nurse Case Management provides leadership and direction to Case Managers, Supervisors and their designated teams, ensuring day-to-day operations align with company and customer guidelines and expectations. This includes overseeing the assignment of referrals, ensuring timely and accurate time and notes entry into the case management database, and maintaining adherence to all Opus Medical guidelines and customer requirements
• The Director is responsible for driving and managing the overall case management workflow, including reviewing documentation for accuracy, quality, and compliance. They conduct regular review of departmental reports, invoices, logs, and expense data on a daily, weekly, and monthly basis to monitor performance and identify areas for improvement
• This role is responsible for upholding and enforcing compliance with all company policies and legal requirements regarding personal health information (PHI and IIHI). The Director ensures quality of service delivery across the department and oversees the resolution of client complaints and escalations
• The Director manages human resources matters within the department, including performance management, coaching and development of supervisors, and partnering with HR on employee relations issues. They are responsible for fostering a culture of accountability, collaboration, and continuous improvement across the case management team
• As a licensed RN, the Director provides clinical oversight and direction for case management clinical activities, ensuring nurses are practicing within scope and in accordance with nationally recognized standards of care. They serve as the clinical authority for the department and may provide guidance and direction to supervisors and case managers on complex referrals
• Additional responsibilities may include participating in marketing and client support activities, attending client meetings, and representing the case management department in organizational and external initiatives. Travel may be required
• Mentor and retain talent across the designated team
• Cultivate a high-performance, collaborative, and inclusive team culture
• Set clear performance expectations and support team development through coaching and feedback
• Work independently while managing competing priorities across a distributed team

Skills

• Active Registered Nurse (RN) license in good standing
• Bachelor of Science in Nursing (BSN)
• Strong working knowledge of case management principles, workers' compensation, and/or managed care options
• Ability to lead, develop, and motivate a high-performing team in a fast-paced, remote environment
• Strong analytical skills with the ability to interpret operational reports and drive informed decisions
• Excellent verbal and written communication skills
• Ability to effectively manage relationships and resolve escalations professionally
• Proficiency in case management platforms and Microsoft
• Thorough understanding of HIPAA and all applicable regulations governing personal health information (PHI and IIHI)
• A minimum of 5-7 years of clinical nursing experience
• A minimum of 3-5 years in case management
• Master's degree in Nursing, Healthcare Administration, or a related field
• Nationally recognized case management certification such as a CCM, ACM, or equivalent
• Additional certifications in workers' compensation, disability management, or utilization review
• Supervisory or leadership experiences

Benefits

• Competitive base salary + performance-based bonus
• Comprehensive benefits package (healthcare, 401k, PTO, etc.)
• Professional development and coaching opportunities

Company Overview