Job Description

The Manager, Case Management is responsible for oversight and coordination of case management activities. The Manager is responsible for supervision of the case management program and strategies, including complex case management, readmission prevention, decreasing length of stay. The Manager participates in and manages committees related to the department and its initiatives.


Responsible for planning, overseeing and evaluating operations of Case Management activities + Monitors documentation in the EMR information pertinent to the patients plan of care
+ Manages activities of Case Managers and Review Analyst LPN; monitors and adjusts staffing and workload as appropriate to achieve departmental goals
+ Oversees department programs and initiatives to assure compliance, optimization and continuous improvement
+ Assists the case management team and social services team in challenging patient discharges and placement needs
+ Ensures that policies and procedures are developed to ensure compliance with all regulatory requirements
Provides essential management functions to assure effective day-to-day operations + Conducts interviews, hires, performance evaluations and other employment actions
+ Monitors and adjusts staffing and workload as appropriate; Budgets within parameters
+ Ensures probationary and annual evaluations are completed per policy
+ Monitors staff performance and provides additional training, counseling, coaching and disciplinary action as necessary
Facilitates departmental accomplishments of case management specific functions + Oversees clinical care coordination, transitional care/discharge planning and quality/variance tracking
+ Monitors and evaluates patient flow throughout admission to discharge
+ Assists and participates in development and implementation of quality initiatives designed to support objectives, such as readmission reduction projects
+ Monitors and presents key metrics for internal and external reporting, such as data on Length of Stay, Readmissions, Case Mix Index and other metrics as defined by the UM committee
+ Maintains the standard for a collaborative process of assessment, planning, facilitation, and advocacy for patients in the organization care
+ Evaluates effectiveness and appropriateness of program; re-design objectives to achieve optimal outcomes

Education:


Bachelor's Degree Master's Degree
Graduate of an accredited, state-approved nursing program


In nursing or related healthcare field


Experience: 5 years case management or nursing experience in an acute care facility with demonstrated progressive leadership responsibility


Skills:


Financial and clinical analytical skills Excellent judgment and creative problem-solving skills, including negotiation and conflict resolution Advanced skills in multitasking, time-management and organization Excellent interpersonal skills while understanding the needs for a positive customer service experience * Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems