Manager Case Management

Job Description

General Summary

Supervises team members on a daily basis to ensure safe, timely and appropriate provision of services. Coach’s team members to problem solve cases to optimize patients’ health, reduce unnecessary care and limit healthcare spending. Monitors team member documentation and data collection to ensure complete, accurate and compliant records. Works collaboratively with the Director, Population Health, management team within the Population Health department, and internal and external stakeholders. Provides oversight and collaboration with the Post-Acute Facilities and the Skilled Transition Nurse Navigator. Position requires 24-hour accountability for planning, organizing, and supervising case management activities. May interact with patients or customers ranging in age from infant to geriatric.

Principal Responsibilities and Tasks

JOB TASK LIST

1. Management of Human Resources:

• Provides team member performance appraisals based on objective criteria & data.
• Assist the Director in recruiting, interviewing, and selection process for vacancies.
• Receive, review, and approve time and attendance requests ensuring staffing is adequate to ensure throughput and safety goals.
• Provide coverage when necessary

2. Team Development:

• Serves as a role model for the Care Coordination team across the continuum and helps promote opportunities for the team to understand the vision of Population Health.
• Coaching, mentoring, and handling disciplinary action as appropriate.
• Assist the Director the coordination and encouragement of professional development for team members.
• Receives requests for seminars, ensures registration information is completed, and prepares check request forms for Director’s signature. Monitors team members’ completion of CEU requirements

3. Management of Financial Resources:

1. Assist the Director in preparation, implementation, and monitoring operating and capital budgets ensuring appropriate cost-savings and revenue maximization.

4. Care Coordination:

• Round daily with team members to identify coordination of care issues and length of stay patients.
• Assisting and monitoring team members to problem solve cases to optimize patients’ health, reduce unnecessary care and limit healthcare spending.
• Coordinate case conferences with appropriate entities to identify patient's health care needs and minimization hospital utilization.
• Works with the Director to identify, integrate and monitor new innovative components into the department.

5. Performance Improvement:

• Assist the Director in setting annual goals and objectives for the Clinical Resource Management.
• Participates in performance improvement activities to improve service and interdepartmental communication in all aspects of the PI plan to team members.
• Identify process problems preventing achievement of goals
• Provide written assessments of problems and proposed solutions

6. Documentation:

• Monitor and track timeliness, accuracy, completeness and compliance of team members' documentation in Meditech & MIDAS.
• Identify inconsistencies in team members’ input of data
• Assist in the development and implementation of automated reports/worksheets.

7. Discharge Planning

• Assess patients, identify discharge needs and coordinate discharge plan when required

1. Develops, implements and revises policies, procedures for Clinical Resources Management. Ensures same are followed to promote accuracy and consistency among team members.
2. Proactively serves as a resource to physicians and team members to provide guidance and understanding of the interdepartmental workings across the continuum of care; i.e. Comprehensive CARE Center and the Clinical Resource Management departments.
3. Post-Acute Care:

• Provides oversight and supervision to the Skilled Transition Nurse Navigator.
• Assist Director in the oversight of the Local Post-Acute Task force to monitor (SNF, LOS/readmission rates/telehealth).
• Participates in committees related to Post-Acute Care.

11. Assist with special projects and other duties as assigned.

Qualifications:
Qualifications

Education and Experience

Education & Training : Current Maryland RN or SW license required. Completion of a Bachelor of Science degree required. Masters preferred.

Work Orientation & Experience: Three to five years’ experience in Case Management and understanding of Utilization Management. Acute care experience preferred. Must have a minimum of two years’ experience of relevant health care management/leadership responsibility. Experience w/ post-acute services is beneficial.

Knowledge, Skills and Abilities

• Knowledge of managed care, discharge planning, utilization, case management and social work is required.
• Highly effective verbal and written skills are required.
• Strong communication skills, self confidence and experience dealing physicians required.
• Excellent analytical and team building skills, as well as the ability to prioritize and work independently is required.
• Must possess the ability to work collaboratively with other disciplines.
• Ability to work with Hospital/Care Coordination related software programs required.
• Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient’s requirements relative to his or her population-specific and age specific needs.

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation:

• Pay Range: $51.82-$77.78
• Other Compensation (if applicable): n/a
• Review the UMMS Benefits Guide

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