--- title: Case Management Supervisor at Sonomaspecialtyhospital description: Sonomaspecialtyhospital is hiring for the Case Management Supervisor role in Sebastopol, CA. Full-time role. See the full description and apply. type: job url: https://www.foundrole.com/jobs/case-management-supervisor-at-sonomaspecialtyhospital-01a0ef76-0c41-7374-9674-eef65a60b214 date: 2026-09-30T00:15:23Z og_description: Join Sonomaspecialtyhospital as Case Management Supervisor in Sebastopol, CA. Pays $104K–$114.4K per year. Full-time role. og_image: https://www.foundrole.com/og/e1gqdh.png breadcrumbs: - label: Home url: https://www.foundrole.com/ - label: Search url: https://www.foundrole.com/jobs --- | | | |---|---| | **Company** | sonomaspecialtyhospital.org | | **Location** | Sebastopol, CA | | **Salary** | $104K/yr - $114.4K/yr | | **Type** | Full Time | | **Posted** | Sep 29, 2026 | ## Description **Job Description** **Position Title:** Case Management Supervisor **Department**: Case Management **Reports To**: Administrator/ CNO **FLSA Status**: Exempt **Job Summary:** The Case Management Supervisor oversees the daily operations of the case management team in a Long-Term Acute Care Hospital. This role ensures that patients with complex, medically intensive needs receive timely admission review, appropriate level-of-care determinations, effective utilization management, and safe, well-coordinated discharge planning. The Supervisor balances clinical quality, regulatory compliance, payer requirements, and length-of-stay goals while providing leadership, coaching, and support to the case management team. **Essential Duties and Responsibilities:** **Team Leadership and Supervision** - Supervise, schedule, and evaluate case managers, social workers, and utilization review staff - Assign caseloads and adjust staffing to meet census and acuity needs - Conduct new-hire orientation, competency validation, and ongoing education - Provide coaching, performance feedback, and corrective action as needed - Serve as a clinical resource and escalation point for complex or difficult cases - Foster a collaborative team culture and support staff retention and engagement **Admission and Utilization Management** - Oversee pre-admission screening and referral review to confirm patients meet LTACH clinical criteria (e.g., InterQual or MCG) - Ensure timely initial authorizations, concurrent reviews, and continued-stay reviews with payers - Manage payer denials, peer-to-peer requests, and the appeals process - Monitor compliance with the CMS LTCH Prospective Payment System (PPS) site-neutral payment criteria and the 25-day average length-of-stay requirement - Track observation of Medicare short-stay outlier and high-cost outlier thresholds **Discharge Planning and Care Transitions** - Ensure every patient has an individualized, interdisciplinary plan of care with a documented discharge plan beginning at admission - Oversee safe transitions to home, home health, skilled nursing, inpatient rehab, acute care, or hospice - Coordinate with physicians, nursing, respiratory therapy, therapy, pharmacy, and families in regular interdisciplinary team (IDT) meetings - Address barriers to discharge, including placement, DME, ventilator or wound care needs, and funding - Lead patient and family education regarding goals of care, prognosis, and post-acute options, including palliative and hospice referrals **Quality, Compliance, and Reporting** - Ensure compliance with CMS Conditions of Participation, Joint Commission or other accrediting body standards, and state regulations - Monitor key metrics: average length of stay, readmission and interrupted-stay rates, denial rates, discharge disposition, and avoidable days - Prepare and present regular reports to leadership and participate in QAPI and utilization review committees - Audit documentation for accuracy, timeliness, and medical necessity - Ensure adherence to patient rights, HIPAA, and ethical standards **Collaboration and Community Relations** - Serve as liaison with referring acute care hospitals, payers, post-acute providers, and community agencies - Support marketing and clinical liaison teams in evaluating appropriate referrals - Participating in physician advisor and interdisciplinary rounds **Performance Measures (Examples):** - Average length of stay within target range and compliant with the LTCH 25-day threshold - Timely completion of authorizations and concurrent reviews - Denial overturn rate and reduction in avoidable days - Discharge disposition and readmission targets - Staff engagement, retention, and competency completion **Education, Training, and Licenses Required:** - Graduate of an accredited nursing program required; Bachelor of Science in Nursing (BSN) preferred - Master's degree in nursing, healthcare administration, or a related field preferred - Licensure and Certification - Current, unrestricted nursing license in the state of practice (LCSW may be considered for a social work-focused supervisory role) - CCM (Certified Case Manager), ACM-RN, or CPHM preferred - BLS preferred **Experience:** - Minimum 2-3 years of case management or utilization review experience in an acute care hospital, LTACH, or post-acute setting\\ - Minimum 1-2 years of supervisory or leadership experience preferred - Working knowledge of Medicare, Medicaid, and commercial payer processes, LTCH PPS, and InterQual or MCG criteria - Knowledge, Skills, and Abilities: - Strong understanding of medically complex conditions (ventilator weaning, wound care, sepsis, multi-system failure, and complex infections) - Excellent communication, negotiation, and conflict-resolution skills - Ability to analyze data and translate it into operational improvements - Proficiency with EMR and case management software and Microsoft Office - Sound clinical judgment and ability to prioritize in a fast-paced environment **Supervisory Requirements (if applicable)**: Case Managers, Social Workers, Utilization Review staff, Discharge Planners **Physical Requirements:** While performing the duties of this job, the position is frequently required to do the following: - Primarily an office and clinical unit environment; may involve prolonged sitting, walking, and computer use. - Ability to lift up to 25 lbs. occasionally. - Exposure to patients with infectious diseases; adherence to infection control and PPE protocols. - May require on-call availability, occasional weekend coverage, or flexibility during high-census periods. ## Skills - Utilization Management - Communicable Diseases - Peer-To-Peer - Patient Rounding - Clinical Judgment - Joint Commission Accreditation - Utilization Review - Clinical Liaison - Post-Acute Care - Performance Management - QAPI - Inpatient Rehabilitation - InterQual - Audit Documentation - Health Insurance Portability And Accountability Act (Hipaa) Compliance - Negotiation - Clinical Quality - Patient/Family Education - Conflict Resolution - Discharge Planning - Supervisory Skills - Mechanical Ventilation - Basic Life Support - Case Management - Durable Medical Equipment (Dme) - Acute Care - Appeals - Content Management System (Cms) - Medicare - PPE Compliance - Referral Processing - Employee Retention - Respiratory Therapy - Microsoft Office - Infection Control - Corrective And Preventive Action (Capa) - Wound Care - Leadership - Employee Engagement - Denials Management - Licensed Clinical Social Worker - Care Planning - Certified Case Manager - Communication - Medical Necessity - Coaching - Electronic Medical Record - Medicaid - Patient Discharge - Regulatory Compliance ## How to Apply [Apply for this position](https://www.foundrole.com/jobs/case-management-supervisor-at-sonomaspecialtyhospital-01a0ef76-0c41-7374-9674-eef65a60b214?utm_source=ai_markdown) ## Related - [Browse all companies](https://www.foundrole.com/companies?utm_source=ai_markdown)