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Corporate Director of Care Management

Be1c5b46 8cdd 4d8c 8447 B37057486176 19000101 000001 · Houston, TX, US, Houston, TX · Active · ADP Workforce Now Recruiting

Job facts

FieldValue
CompanyBe1c5b46 8cdd 4d8c 8447 B37057486176 19000101 000001
TitleCorporate Director of Care Management
Normalized title-
Department / team-
LocationHouston, TX, United States
Work model-
Employment typeFull Time
Salary-
Statusactive
ATS providerADP Workforce Now Recruiting
Posted / first seen2026-06-10 / 2026-06-11
Changed / last seen2026-06-21 / 2026-06-21

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Linked records

CompanyBe1c5b46 8cdd 4d8c 8447 B37057486176 19000101 000001
Source1e9dd4ff-96bd-40d4-838d-0d6ed2d9074b
ATS providerADP Workforce Now Recruiting

Description

Corporate Director of Care Management Nexus Health Systems Nexus Health Systems is seeking an experienced and strategic healthcare leader to serve as the Corporate Director of Care Management . This role provides operational and clinical oversight for all case management, utilization review, discharge planning, and care coordination functions across multiple Nexus facilities. The Corporate Director will partner closely with executive leadership, physicians, nursing teams, and interdisciplinary departments to drive exceptional patient outcomes, regulatory compliance, patient throughput, and financial performance. This position plays a critical role in supporting patients with neurodevelopmental disorders and co-occurring complex behavioral and medical conditions across the continuum of care. About Nexus Health Systems Nexus Health Systems is a multi-facility healthcare organization specializing in complex medical, neurobehavioral, rehabilitation, and behavioral healthcare services for pediatric and adult populations. Our mission-driven team is committed to delivering compassionate, evidence-based care while improving quality of life for patients and families. Position Summary The Corporate Director of Care Management will lead system-wide care management operations including utilization review, discharge planning, transition of care initiatives, and interdisciplinary care coordination. This leader will standardize workflows, optimize length of stay, strengthen payer relationships, and ensure compliance with CMS Conditions of Participation, accreditation standards, and organizational policies. Key Responsibilities Operational & Clinical Leadership Lead and standardize care management operations across assigned facilities Oversee utilization review, discharge planning, care coordination, and transition of care processes Ensure compliance with CMS Conditions of Participation, Joint Commission/DNV standards, and URAC principles Establish and oversee Utilization Management Committee operations Collaborate with physician advisors regarding medical necessity determinations and documentation quality Implement InterQual® criteria for admission status, continued stay reviews, and discharge readiness Promote Neurodevelopmental Disabilities (NDD)-informed care practices throughout care management workflows Support interdisciplinary collaboration to improve patient throughput and continuity of care Quality & Compliance Monitor regulatory compliance related to utilization review and discharge planning Lead performance improvement initiatives and accreditation readiness efforts Conduct audits related to documentation, appeals, timeliness, and care coordination practices Promote patient safety and continuous quality improvement across facilities Ensure accurate documentation supporting medical necessity and fiscal reimbursement Patient Advocacy & Experience Champion person-centered discharge planning and patient advocacy initiatives Support sensory-friendly environments and communication accommodations for neurodiverse patients Assist patients and families with community resources, financial assistance, and care transitions Collaborate with patients, caregivers, and healthcare teams to prevent fragmentation of services Leadership & Staff Development Provide mentorship, coaching, and operational guidance to care management teams Oversee recruitment, onboarding, and professional development for department staff Develop competency pathways and leadership development programs Encourage professional certification attainment including CCM, ACM-RN, ACM-SW, and CPHQ Facilitate annual education and training related to InterQual®, CMS regulations, and best practices Financial & Strategic Oversight Optimize length of stay and reduce avoidable days through proactive utilization management Monitor throughput, payer denials, appeals, case mix, and departmental performance metrics Develop and manage departmental budgets and resource allocation Collaborate with payers and physician advisors to support efficient, cost-effective care delivery Ensure equitable care management services regardless of payer source Qualifications Education Bachelor of Science in Nursing (BSN) required Master of Science in Nursing (MSN) required Experience Minimum 7 years of progressive leadership experience in hospital case management Multi-site leadership experience required Strong background in utilization review, discharge planning, and care coordination Experience working with neurodevelopmental, behavioral health, and medically complex populations strongly preferred Knowledge of CMS regulations, Joint Commission/DNV standards, and utilization management practices Licensure & Certifications Current and valid Texas Registered Nurse (RN) license required Case Management Certification required (ACM, CCM, CMGT, FAACM, or equivalent) Certification must be obtained within two years of hire if not currently held Preferred Skills Expert knowledge of CMS Conditions of Participation and utilization management principles Proficiency with InterQual® criteria and medical necessity determinations Strong leadership, communication, and interdisciplinary collaboration skills Experience with EHR systems and healthcare analytics Exceptional organizational, strategic planning, and operational management abilities Compassionate, patient-centered leadership style with strong advocacy skills Why Join Nexus Health Systems? Mission-driven healthcare organization focused on improving lives Collaborative executive leadership environment Opportunity to shape and standardize care management across multiple facilities Meaningful work supporting medically and behaviorally complex patient populations Competitive compensation and comprehensive benefits package Professional growth and leadership development opportunities

Full job record

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Last Seen At2026-06-21 13:27:14Z
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    "response_bytes": 15999
  },
  "detail_errors": []
}
Get this page with API

Rendered from the bluedoor Job Postings API. Reproduce it:

GET https://api.bluedoor.sh/job-postings/v1/jobs/eecfa9480ce497c88a7d28a5958f41a4e451a430?include=descriptionJSON
GET https://api.bluedoor.sh/job-postings/v1/orgs/1c0a387d-799f-47d5-aee7-70dbc0bf2182JSON
GET https://api.bluedoor.sh/job-postings/v1/sources/1e9dd4ff-96bd-40d4-838d-0d6ed2d9074bJSON
GET https://api.bluedoor.sh/job-postings/v1/jobs/eecfa9480ce497c88a7d28a5958f41a4e451a430/eventsJSON

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