Manager, Clinical Care Coordination and Discharge Planning-(West Shore)

Clinical Care Coordination And Discharge Planning Manager

The Manager oversees the day-to-day operations of the Clinical Care Coordination and Discharge Planning Department under the direction of the Director. The Manager is accountable for achieving established goals and targets through actively engaging multiple disciplines and associates. This role is expected to lead efforts to evaluate, develop, implement, redesign, and modify Discharge Planning practice standards. The Manager works closely with department staff in an effort to safely, effectively, and efficiently move patients across the continuum of care.

Responsibilities:

1. Collaborate with the Director to ensure effective processes and systems are established and maintained to meet departmental goals.
2. Oversee daily operations of the Discharge Planning staff under the direction of the Director. Ensure productivity standards are met.
3. Utilize expert leadership and critical thinking skills to efficiently coordinate and direct discharge planning expectations among all health care providers while maximizing use of resources. Take a leadership role in the mentoring and monitoring of department staff. Participate in leadership development.
4. Hire and terminate staff as necessary. Establish and monitor performance and provide feedback and guidance to staff. Conduct annual performance evaluations.
5. Function as a resource person for the care management and denial management processes. Develop and implement processes for timely and accurate documentation of appropriate data relating to concurrent denials. Assure regulatory compliance in determining denial of service and/or providing notices of non-coverage.
6. Ensure training programs address identified needs of department staff.
7. Maintain a tracking system for overseeing and monitoring progress toward established goals and objectives of the discharge planning program.
8. Collaborate with other UPMC departments to establish mechanisms to address issues related to discharge planning, track avoidable day/delay documentation, and report trends/barriers to Director.
9. Participate in the development of the Clinical Care Coordination and Discharge Planning department annual budget and plans for department needs under the direction of and in collaboration with the Director. Monitor actual expenses against budget and report variances.

Master's Degree Required. Minimum of five years of experience in discharge planning or care coordination, or similar experience managing departmental operations. Including at least one year experience in leadership required.

Knowledge and Skills:

• Expertise in care management, discharge planning and utilization review processes.
• Ability to build credible and effective relationships with physician and executive leadership.
• Understanding of clinical, financial, and regulatory processes.
• Ability to prepare and critically analyze data, make appropriate recommendations toward resolution, and follow-through of identified action.
• Expertise in interpersonal relationships, organizational relations.
• Effective communication, negotiation, and conflict resolution skills.
• Strong analytical and critical thinking skills.
• Demonstrated leadership capabilities.
• Strong quality improvement expertise.
• Knowledge of health care revenue cycle processes and requirements.

Licensure, Certifications, and Clearances:

• Licensure: RN, LSW/LCSW, or education-appropriate license required.
• Certification: CCM/ACM, LCSW or UPMC approved certification required.
• Licensed Clinical Social Worker (LCSW) OR Licensed Social Worker (LSW) OR Other Healthcare Professional Licenses for Discharge Planning OR Registered Nurse (RN)
• Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.

UPMC is an Equal Opportunity Employer/Disability/Veteran