Director of Care Management & Social Work Location:

Phoenix, AZ Employment Type:

Full-Time | Leadership

POSITION SUMMARY

We are seeking an experienced healthcare executive to provide strategic direction, overall leadership, and operational oversight for our enterprise-wide Care Coordination departments, including Inpatient Care Management, Utilization Management, and Social Work. This role serves as a key operational pillar-ensuring close alignment between care coordination and nursing leadership, developing family-centered care management models, and implementing population health initiatives. The leader will oversee vendor relationships, drive transition-to-care navigation programs, improve clinical outcomes through clinical innovation, and manage utilization to support cost-effective, high-quality pediatric care.

KEY RESPONSIBILITIES

Strategic Leadership & Compliance:

Partner with executive leadership to establish clinical and financial Key Performance Indicators (KPIs). Direct day-to-day operations for Case Management, Utilization Management, and Social Work to ensure full compliance with EMTALA, legal standards, and evidence-based clinical practices.

Operational Oversight & Quality:

Evaluate operational efficiency, establishing robust control mechanisms for hospital scheduling, insurance verifications, and financial clearances. Lead continuous quality improvement initiatives across all assigned units.

Financial & Resource Management:

Formulate and manage departmental operating budgets. Analyze operational and financial metrics, evaluate emerging technologies to streamline care delivery, and manage external vendor partnerships.

Interdisciplinary Collaboration:

Maintain active collaboration with Nursing, Managed Care, Revenue Cycle, Health Information Management (HIM), and Medical Group leadership to streamline care transitions and resolve complex cross-departmental bottlenecks.

Team Development & Mentorship:

Build a high-performing team by fostering professional growth, establishing clear performance expectations, and facilitating targeted education and training opportunities.

QUALIFICATIONS & REQUIREMENTS

Education Required:

Bachelor's degree in Nursing, Social Work, Healthcare Administration, Public Health, or a related field (or an equivalent combination of education and experience).

Preferred:

Master's degree in Nursing, Management, Organizational Development, Healthcare Administration, or Social Work. Experience 10+ years of progressive experience in Case Management or Social Work. 5+ years of leadership experience in an acute care hospital environment. 5+ years leading cross-functional departments supporting patient/family resources, community alignment, and/or utilization management (e.g., Social Work, Financial Counseling, Case Management). Pediatric acute care experience is highly preferred.

Technical Skills & Expertise Required:

Strong understanding of revenue cycle operations at the clinical/financial intersection; working knowledge of third-party reimbursement models, patient access, financial clearance, and

ICD-9/ICD-10

coding; proficiency with MCG and InterQual criteria.

Preferred:

Deep familiarity with Milliman guidelines and Allscripts Care Management (ACM).

Core Competencies:

Exceptional analytical, problem-solving, and conflict-resolution skills; proven ability to influence and lead cross-functional teams; strong computer literacy.

Certifications & Credentials Required:

Valid Arizona Department of Public Safety (DPS) Fingerprint Clearance Card.

Preferred:

Active State of Arizona RN License (or compact state equivalent with multi-state privileges).

Preferred:

National certification in Case Management (CCM), Social Work (LCSW), or equivalent credential.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA). This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.