Supv, Care Management

The position provides comprehensive care coordination for patients as assigned and assesses the patient’s plan of care. Develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, advocating and facilitating options and services to meet the patient’s health care needs. Assists the Manager, Case Management with the daily operational activities by monitoring quality and effectiveness of workflow, problem resolution and troubleshooting issues, and processes improvement plan to ensure optimum efficiency for the department and compliance with all regulatory and licensing requirements.

This position provides leadership of patient care services and directs supervision of staff, conducts performance evaluations and implements disciplinary actions. Formulates employee orientation structure and provides ongoing education and information to staff regarding best practices, Case Management structures, functions and use of clinical guidelines. This position works independently receiving supervision of work activities from the Manager of Case Management.

• Leadership
  1. Provides guidance, mentoring, and direction as appropriate for ongoing staff development and retention. Rotates on-call responsibilities with other assigned staff.
  2. With the Medical Director of Utilization Management and the Care Management leadership team plans, recommends and implements approved protocols, policies, and guidelines and supports overall organizational values and mission.
  3. Participates in hospital and departmental operational initiatives to evaluate and improve reimbursement, denials, level of care, goal length of stay and improve delivery care methods.
  4. Functions as part of a leadership team with the Lead CM, Manager of CM and Director of CM on operational changes, quality improvement and or productivity issue for the Care Management Department.
  5. Coordinates work activities of assigned staff to ensure achievement of established goals, objectives and outcomes.
  6. Leads employees through ongoing goal setting, training and performance feedback.
  7. Evaluates performance of case managers and completes performance appraisals.
  8. Provides team leadership, demonstrates strong, consistent clear communication and serves as a central point of information informing all team members.
  9. Keeps families and patients involved and informed as demonstrated by feedback. 10. Cultivates and maintains effective interaction/communication with members of the interdisciplinary care team and families to drive the care coordination process and to facilitate continuity of patient care.
• Coordination of care
  1. Manages a defined service line patient population to achieve optimal discharge and continuity of care outcomes in a manner that promotes sound financial stewardship and patient-family advocacy.
  2. Completes an initial screen of all patients on admission (not to exceed within 24 hours of admission) utilizing MCG criteria to identify needs related to care coordination and/or discharge planning.
  3. Leveraging MCG and other evidence-based guidelines, coordinates, development and implementation of a comprehensive discharge care plan in collaboration with the clinical care team.
  4. Ensures plan of care is in place with all team members. Proactively collaborates with members of the interdisciplinary clinical care team to define and document a clear and comprehensive treatment plan, including post-discharge needs. Identifies and facilitates resolution of variances in the plan of care that may impact length of stay. Facilitates referral to other disciplines, and monitor for appropriate follow-up.
  
  5. Facilitates and provides on-going communication with…