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CentraState Healthcare System, headquartered in Freehold, New Jersey, is a leading nonprofit healthcare provider dedicated to serving the community. Its comprehensive network includes CentraState Medical Center, a community-focused hospital, along with an ambulatory campus, two senior living facilities, three free-standing community health pavilions, and a charitable foundation. As the third-largest employer in Monmouth County, CentraState has earned repeated recognition as a Great Place to Work-Certified™ company, reinforcing its reputation as an exceptional workplace.

The Manager Inpatient Care Management is responsible for the oversight of daily operations of Care Management and Social Work functions, including utilization management, care coordination, and discharge planning. This role ensures the delivery of medically appropriate, cost-effective care while maintaining compliance with regulatory and accreditation requirements. The Manager collaborates with medical staff, interdisciplinary teams, and external providers to optimize patient progression, reduce length of stay and denials, and ensure timely and appropriate transitions of care. The role is accountable for staff performance, operational effectiveness, and achievement of key departmental outcomes.

• Oversees daily operations of Care Management and Social Work, including utilization review, care coordination, and discharge planning.
• Supervises and supports case managers and social workers, including staffing, work assignments, and performance management.
• Ensures timely and appropriate utilization review processes, including medical necessity determinations, payer communication, and escalation to Physician Advisors.
• Monitors compliance with CMS regulations and utilization management requirements, including Condition Code 44, MOON, IMM, and HINN notices.
• Oversees documentation standards and completion of utilization reviews, payer communications, and physician advisor referrals in accordance with policy.
• Partners with medical staff leadership and Physician Advisors to address level of care concerns, denials, and length of stay opportunities.
• Leads interdisciplinary collaboration to facilitate progression of care and timely discharge planning.
• Monitors and drives performance in key metrics, including length of stay, avoidable days, discharge timeliness, and denial rates.
• Identifies barriers to progression of care and implements strategies to improve throughput and reduce delays.
• Conducts audits and reviews to ensure quality, regulatory compliance, and adherence to departmental standards.
• Leads process improvement initiatives to enhance care management workflows and patient flow.
• Establishes productivity standards and ensures appropriate workload distribution across the team.
• Participates in hospital, medical staff, and system committees, including the Utilization Review Committee.
• Maintains collaborative relationships with internal departments and external providers across the continuum of care.
• Maintains clinical competency to support departmental needs, including coverage as needed.
• Other duties as assigned by management

• Bachelor's degree in Nursing Or Social Work required.
• Master's degree in Nursing Or Social Work preferred.
• Minimum of 3–5 years of acute care case management or utilization review experience required.
• Experience with utilization management regulations and discharge planning required.
• Prior leadership experience preferred.
• Valid NJ RN License required, Or Valid Licensed Social Worker required.
• Case Management Certification (CCM, ACM), preferred
• Knowledge of relevant and state utilization review and appeals requirements
• Strong professional, organizational, and interpersonal skills to effectively relate with all members of the healthcare team.
• Rapid cycle change or clinical performance improvement expertise
• Data and computer skills
• Excellent communication, negotiation, and conflict resolution skills

CentraState Healthcare System, in partnership with Atlantic Health System, is a fully accredited, not-for-profit, community-based health system dedicated to providing comprehensive health services in central New Jersey. Beyond offering a wide range of advanced diagnostic and treatment options, CentraState is committed to being a valuable health partner, focusing on disease prevention, promoting healthy behaviors, and helping individuals of all ages live well.

Located in Freehold, CentraState includes a 284-bed acute-care hospital, a dynamic health and wellness campus, two award-winning senior living communities, a charitable foundation, and convenient satellite health pavilions. These pavilions offer primary care, specialty physician practices, and access to outpatient services such as lab work and physical therapy.

CentraState is proud to be among the less than two percent of hospitals nationwide to earn Magnet® designation for nursing excellence five times. Additionally, it has been recognized as a Great Place to Work-Certified™ Company by Great Place to Work® for four consecutive years.

Joining CentraState means becoming part of a pioneering healthcare facility committed to high-quality, patient-focused care. We invite you to make a difference in our community and advance your career with us. We support our employees with work/life balance initiatives, tuition assistance, career advancement opportunities, and more.

Discover why our employees love their jobs and being part of the CentraState family!

CentraState Health System offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members.

What We Offer:

• Medical, Dental, Vision, Prescription Coverage (30 hours per week or above for full-time and part-time team members)
• Life & AD&D Insurance
• Long-Term Disability (with options to supplement)
• 403(b) Retirement Plan with employer match
• 401(a) Retirement Plan with employer contribution
• PTO
• Tuition Reimbursement
• Well-Being Rewards
• Employee Assistance Program (EAP)
• Fertility Coverage, Healthy Pregnancy Program
• Flexible Spending & Commuter Accounts
• Pet, Home & Auto, Identity Theft and Legal Insurance
• Growth Opportunity and Workforce Development Initiatives
• Continuing Education / Onsite Training
• A warm, welcoming company culture based upon mutual respect and a collaborative goal of providing excellent patient care
• Concierge Services with Work & Family Benefits
• Magnet recognized healthcare facility

Compensation Range: $97,500 - $165,750 annually

The compensation above reflects the established range from CentraState Healthcare System (CSHS) for this position at the time the job was posted. CSHS considers many factors to determine compensation, including education, experience, skills, licenses, certification, and training. As such, team member compensation may fall outside this range.

Additionally, the compensation range reflects base salary and does not include extra shift rates or incentives tied to quality, productivity, etc., as applicable.

The benefits outlined also reflect CSHS' policy at the time of posting. Benefits as are made available to other similarly situated team members of CSHS, although participation is at all times in accordance with and subject to the eligibility and other provisions of such plans and programs. CSHS may modify its benefits plans or programs at any time.

CSHS is proud to comply with all pay equity and pay transparency laws.