Director, RN Case Management Job at InnovAge (Denver, Colorado)

Job Description

The Director, RN Case Management provides strategic and operational leadership for InnovAge’s RN Case Management division, overseeing all inpatient care coordination, post-acute transitions, utilization management, and related workflows across the PACE program. The Director reports to the VP of Nursing Operations and leads the RN Case Management team, ensuring compliance with regulatory requirements, operational excellence, and alignment with InnovAge’s mission and care model. This role ensures high-quality participant outcomes, efficient care transitions, and consistent application of case management standards. The Director actively partners with interdisciplinary teams, facility leaders, and community partners to optimize participant health outcomes and minimize unnecessary hospital readmissions.

Job Responsibility

Leads, develops, and supports RN Case Managers, including recruitment, onboarding, coaching, and performance management
Establishes division-wide workflows, standards, and best practices for acute and post-acute care coordination
Partners with the VP of Nursing Operations and clinical leadership to implement staffing strategies, workload balancing, and coverage expectations for case management services
Oversees daily operational execution of case management functions, ensuring timely coordination, documentation, and communication across care teams
Ensures RNs receive training and ongoing development to maintain clinical competency in transitional care and utilization management
Oversees the experience of participants during hospitalization and post-acute stays, ensuring high-quality transitions and strong communication
Responds to escalated participant concerns in coordination with Center Directors, providers, and Quality teams
Ensures RN Case Managers collaborate effectively with participants, families, caregivers, and IDT members to support person-centered care plans
Monitors service KPIs and drives improvements in communication, responsiveness, and participant satisfaction during transitional care periods
Ensures division performance aligns with quality metrics related to readmissions, skilled days, length of stay, and transition-of-care outcomes
Ensures RN Case Management workflows comply with all federal and state regulations and PACE requirements
Partners with QA, Compliance, and Center Operations on audits, corrective action plans, monitoring, and documentation standards
Ensures appropriate and compliant review of medical necessity, levels of care, discharge planning, and utilization standards
Builds and maintains strong relationships with hospitals, SNFs, and community-based partners to enhance transitional care pathways
Supports market teams in preparing for enrollment growth, expansion, and network development through standardized case management practices
Represents the RN Case Management division in external partner discussions, strengthening care coordination channels
Monitors participant retention and collaborates on strategies to address barriers related to post-acute care experiences
Oversees performance related to ED/IP utilization, SNF days, and avoidable hospital readmissions
Reviews utilization data and trends to identify opportunities for efficiency, improved care transitions, and cost stewardship
Partners with Finance, Population Health, and Transformation teams to analyze drivers of cost and implement interventions to improve performance and reduce unnecessary utilization

Requirements

Bachelor’s degree in Nursing (BSN)
Current state-issued Registered Nurse (RN) license
5+ years of experience in acute care coordination, case management, or discharge planning
2+ years of leadership or supervisory experience in a clinical setting
Demonstrated success in performance management, operational execution, and cross-functional collaboration
Experience in quality improvement, compliance adherence, or care coordination oversight

Nice to have

3+ years of experience coordinating care and discharge planning
3+ years of experience in geriatrics or value-based care models
Certification as a Gerontological Nurse or related specialty
Bilingual preferred

What we offer

medical/dental/vision insurance
short and long-term disability
life insurance and AD&D
supplemental life insurance
flexible spending accounts
401(k) savings
paid time off
company-paid holidays

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Director, RN Case Management

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