Director of Care Management | RN Required | Multi-Hospital Health System | New England

Competitive Compensation | Comprehensive Benefits | Relocation Assistance

Experienced Care Management, Case Management, and Utilization Review Leaders seeking broader system-level responsibility are encouraged to apply.

Galileo Search is seeking an accomplished RN leader to direct Care Management, Utilization Management, Discharge Planning, and Transitions of Care across a progressive multi-hospital health system in New England. This highly visible leadership opportunity is ideal for a strategic healthcare executive passionate about care coordination, operational excellence, patient outcomes, and advancing value-based care in a complex healthcare environment.

The Director will provide system-wide leadership for inpatient Care Management services, working collaboratively with executive leadership, physicians, nursing leaders, case managers, social workers, revenue cycle teams, and community partners. This role will play a critical part in optimizing resource utilization, improving patient throughput, strengthening care transitions, reducing avoidable readmissions, and ensuring regulatory compliance throughout the continuum of care.

Beyond operational leadership, this individual will help shape the strategic direction of Care Management across the organization, driving standardization, process improvement, and best practices that enhance both patient outcomes and organizational performance.
This is a high-impact leadership opportunity that offers significant executive visibility and the ability to influence initiatives affecting patients, providers, caregivers, and communities across an integrated healthcare system.

The region offers an exceptional quality of life, access to outdoor recreation, thriving communities, and a highly respected healthcare environment. This opportunity is ideal for leaders seeking executive exposure, broad influence, and the ability to impact care delivery across an integrated health system.

New England

• Lead Care Management, Utilization Review, Discharge Planning, Care Coordination, and Transition of Care functions across a multi-hospital health system
• Develop and implement system-wide strategies, operational plans, and performance initiatives for Care Management services
• Standardize Care Management and Utilization Review processes across multiple hospitals and care settings
• Drive improvements in patient outcomes, throughput, patient experience, length of stay, and cost-effective care delivery
• Support organizational initiatives related to value-based care, population health, and regulatory compliance
• Oversee inpatient and outpatient case management, social work, discharge planning, and care coordination programs
• Ensure timely patient assessments, discharge planning, and transition-of-care activities
• Collaborate with physicians and interdisciplinary teams to address clinical, psychosocial, and financial barriers to care
• Lead readmission reduction initiatives and post-acute care transition strategies
• Direct utilization review, medical necessity review, and payer compliance activities
• Partner with physician advisors and clinical documentation teams to support accurate patient status determinations
• Lead denial prevention and appeals strategies to improve reimbursement and minimize revenue loss
• Analyze utilization patterns and length-of-stay data to identify performance improvement opportunities
• Ensure compliance with CMS, accreditation standards, state regulations, and payer requirements
• Build, mentor, and develop high-performing Care Management teams throughout the health system

• RN required
• Bachelor's degree in Nursing required, and a Master's degree in a healthcare-related field required
• Minimum of 7-10 years of progressive leadership experience in Care Management, Case Management, Utilization Review, Population Health, or related disciplines
• Minimum of 5 years of management experience within a hospital or integrated health system environment
• Multi-site or multi-hospital leadership experience preferred
• Demonstrated success improving utilization management, denial prevention, throughput, length of stay, and care transition outcomes
• Certified Case Manager (CCM), Accredited Case Manager (ACM), or related certification strongly preferred
• Strong knowledge of utilization review, care coordination, discharge planning, payer requirements, and regulatory compliance
• Proven ability to lead change, influence stakeholders, and drive system-wide performance improvement initiatives
• Exceptional communication, relationship-building, and leadership skills

Galileo Search, LLC partners with hospitals and healthcare organizations across the United States to identify, recruit, and retain the industry's most accomplished professionals and executives. Our clients include community and critical access hospitals, health systems, academic medical centers, and Fortune 500 corporations. To learn more about Galileo Search, LLC, visit our website at www.galileosearch.com

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