Full time
Day Shift
The Nurse Manager – Case Management provides strategic and operational leadership for inpatient care coordination, case management, and utilization management services. This role partners with physicians, hospital leadership, and system stakeholders to ensure high‑quality, cost‑effective, patient‑centered care while optimizing throughput, length of stay, and regulatory compliance.
Key Responsibilities
Lead Care Coordination, Case Management, and Utilization Management teams, including staff development, performance management, and engagement
Promote evidence‑based nursing practice, patient safety, and interdisciplinary collaboration
Oversee utilization management processes, level‑of‑care determinations, concurrent reviews, denials management, and appeals
Collaborate with Physician Advisors, Finance, Revenue Integrity, Patient Access, and Compliance teams
Monitor CMS and payer compliance (IMM/MOON, authorizations, documentation standards)
Drive patient flow initiatives to support timely admissions, transitions of care, and discharge planning
Analyze data, trends, and outcomes to support quality improvement and financial stewardship
Participate in hospital and system‑wide committees and strategic initiatives
Required Qualifications
Active Registered Nurse (RN) license in Pennsylvania
BSN required; MSN or Master’s in related field preferred
Minimum 5 years of healthcare experience, including leadership or management
Experience in care coordination, case management, utilization management, or patient flow
Strong communication, analytical, and change‑leadership skills
Preferred Qualifications
Master’s degree (MSN or related healthcare field)
Experience in utilization management, denial management, and payer relations
Prior leadership experience in a large health system or multi‑department environment
Knowledge of CMS regulations, payer requirements, and care management best practices
About Us: St. Mary Medical Center is a beautiful 53-acre state-of-the-art facility comprised of more than 700 physicians, nearly 3,000 colleagues, and 1,100 volunteers committed to providing quality care delivered with compassion and respect. St. Mary attracts top doctors, introduces cutting-edge technologies and implements advanced procedures to meet the healthcare needs of the people it serves, including the nearly 630,000 residents of Bucks County.
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.
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 123,000 colleagues and nearly 27,000 physicians and clinicians caring for diverse communities across 26 states. Nationally recognized for care and experience, the Trinity Health system includes 88 hospitals, 135 continuing care locations, the second largest PACE program in the country, 136 urgent care locations and many other health and well-being services. Based in Livonia, Michigan, its annual operating revenue is $21.5 billion with $1.4 billion returned to its communities in the form of charity care and other community benefit programs.
