Opus Medical is hiring a Director of Nurse Case Management to provide strategic leadership and oversight within our Clinical Operations Department. This role is pivotal in ensuring high-quality, cost-effective case management services, maintaining strict compliance, and driving departmental performance and growth. You will partner closely with the SVP of Clinical Operations and other key stakeholders.

What You'll Do

Provide leadership and direction to Case Managers, Supervisors, and their teams to ensure operations align with company guidelines and client expectations.
Oversee referral assignment, timely and accurate data entry into case management systems, and strict adherence to Opus Medical protocols.
Drive and manage the overall case management workflow, reviewing documentation for accuracy, quality, and compliance.
Conduct regular analysis of departmental reports, invoices, and performance data on a daily, weekly, and monthly basis.
Uphold and enforce compliance with all company policies and legal requirements regarding personal health information (PHI and IIHI).
Ensure quality of service delivery and oversee the resolution of client complaints and escalations.
Manage human resources matters including performance management, coaching supervisors, and partnering with HR on employee relations.
Foster a culture of accountability, collaboration, and continuous improvement across the case management team.
Provide clinical oversight and direction for case management activities as a licensed RN, ensuring practice within scope and standards.
Serve as the clinical authority for the department, providing guidance on complex referrals.
Participate in marketing and client support activities, attend client meetings, and represent the department in organizational initiatives.
Mentor, retain talent, and cultivate a high-performance, collaborative, and inclusive team culture.
Set clear performance expectations and support team development through consistent coaching and feedback.
Work independently while effectively managing competing priorities across a distributed team.

What We're Looking For

Active Registered Nurse (RN) license in good standing.
Bachelor of Science in Nursing (BSN).
Minimum of 5-7 years of clinical nursing experience.
Minimum of 3-5 years in a case management role.
Strong working knowledge of case management principles, workers’ compensation, and/or managed care.
Proven ability to lead, develop, and motivate a high-performing team in a fast-paced, remote environment.
Strong analytical skills with the ability to interpret operational reports and drive informed decisions.
Excellent verbal and written communication skills.
Ability to effectively manage relationships and resolve escalations professionally.
Proficiency in case management platforms and Microsoft Office.
Thorough understanding of HIPAA and all applicable regulations governing personal health information.

Nice to Have

Master’s degree in Nursing, Healthcare Administration, or a related field.
Nationally recognized case management certification such as CCM, ACM, or equivalent.
Additional certifications in workers' compensation, disability management, or utilization review.
Supervisory or leadership experience.