Position Summary

Baystate Health is seeking a Supervisor, Case Management to provide leadership and oversight of case management and utilization review activities. This role supports effective patient care coordination, appropriate resource utilization, and timely transitions across the healthcare continuum. Working collaboratively with clinical teams, physicians, and hospital leadership, the supervisor promotes quality patient outcomes, efficient hospital operations, regulatory compliance, and a positive team environment.

Job Responsibilities

• Oversee daily case management and utilization review workflows, assignments, and staffing to support departmental goals and performance expectations.
• Lead team orientation, training, scheduling, performance management, and professional development while fostering a collaborative, accountable, and supportive work environment.
• Provide guidance to case managers on evidence-based practices, clinical guidelines, and appropriate case management interventions.
• Participate in case management and utilization review committees, communicate emerging issues, and collaborate regularly with the Physician Advisor.
• Partner with Denials and Appeals Specialists to support effective communication, collaboration, and resolution of utilization management concerns.
• Assess admission appropriateness, level of care, and continued stay using established screening criteria, clinical expertise, and departmental guidelines.
• Communicate utilization review findings and level-of-care concerns to the healthcare team and coordinate Physician Advisor involvement when needed.
• Monitor patient progression, anticipated length of stay, and discharge needs to support timely, appropriate care and transitions to the next level of care.
• Collaborate with physicians and interdisciplinary teams to address barriers to discharge, placement challenges, and variances from the plan of care.
• Educate physicians and healthcare team members regarding length of stay, medical necessity, and potential denials.
• Ensure compliance with departmental policies, hospital requirements, mandatory education, and applicable regulatory standards.

Required Qualifications

• Associate Degree in Nursing (ADN).
• Current Massachusetts Registered Nurse (RN) license.
• Minimum of three years of case management experience.

Preferred Qualifications

• Bachelor of Science in Nursing (BSN).

Schedule: Full-time, 40 hours per week.

Why Baystate Health?

We strive to be the place where you can build the career you deserve. Join Baystate Health and make a difference in the lives of the patients and communities we serve. Apply today — YOU belong at Baystate!

Our Compensation Philosophy

Baystate Health offers competitive total compensation, including pay, benefits, and other employee recognition programs. Base pay decisions consider a variety of factors, including knowledge and skills, relevant experience and training, education, certifications, licensure, and other business and organizational factors. The stated base pay range does not include the comprehensive benefits package or any applicable incentive payments.

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Certifications:

Compensation

Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.

Minimum - Midpoint - Maximum

Equal Employment Opportunity Employer