Care Mgmt Svcs Outpatient Manager

CARE MGMT SVCS OUTPATIENT MANAGER

Organization: UNM Sandoval Regional Medical Center

Location: Rio Rancho, NM

Compensation: $40.04/hr – $56.28/hr

Department: OP Care Management Svcs

Employment: 1.00 FTE, Full Time, Shift: Days

Position Summary: Responsible for coordination, implementation and evaluation of Care Management for UNM Hospital. Responsible for the case management delivery and monitoring quality for care management staff. Provide care management services for UNM Hospital when necessary. Ensure adherence to Hospitals and departmental policies and procedures. Patient care assignment may include neonate, pediatric, adolescent, adult, and geriatric age groups.

• Follow patient safety–related policies, procedures and protocols.
• Develop efficient organizational structure; supervise employees, select, terminate, train, educate, correct deficiencies, perform appraisals, issue discipline, counsel, schedule work assignments; encourage staff teamwork and growth initiatives.
• Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes.
• Coordinate response to external requests for presentations, site visits and consultation regarding Care Management.
• Perform assessment, data collection, obtain, review, and analyze information in collaboration with the patient, family, significant others, health care team members, employers, and others as appropriate.
• Identify and report/correct environmental conditions and/or situations that may put a patient at undue risk.
• Use interpersonal communication strategies with individuals as well as groups of patients, families, significant others, and staff to achieve expected outcomes and patient/family and health care team satisfaction.
• Report potential or actual patient safety concerns, medical errors and/or near misses in a timely manner.
• Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may "not seem right".
• Perform utilization review and management, including quality review and case review for third party payor requirements.
• Evaluate and monitor utilization review process and the collection of data.
• Participate in the assessment, development, implementation, evaluation, and attendance of educational needs for personnel based on quality assurance indicators.
• Adjust staffing to meet needs and to provide adequate coverage of the department.
• Provide leadership in case management through identification of problems and opportunities for improvement, program planning, implementation, and evaluation.
• Participate in orientation, continuing education of Care management staff and other health care team members as appropriate.
• Maintain and revise as necessary hospital policies, procedures objective to maintain quality assurance program, and safety standards.
• Provide clinical supervision to RN Case Managers, conduct random chart reviews and ensure appropriate distribution of assignments.
• Collaborate with medical staff and other hospital personnel to plan, develop, implement and evaluate protocols, patient care policies and procedures and standards of care; develop collaborative relationships with post-acute providers/services and community health care agencies facilitating and supporting quality care in area of clinical expertise; act as a resource on complex patient care activities.
• Organize, direct and coordinate transitional care for patients and/or family members within post-acute facility.
• Evaluate the plan of care and goals for discharge home from skilled facility as well as monitor utilization review process and the collection of data for post acute placements.
• Adhere to and promote the core expectations of the Patient Centered Medical Home or Patient Centered Specialty Practice as applicable.
• Serve as the contact point, advocate, and the informational resources for patients, care team, family/caregiver(s), payers, and community resources within post-acute facility.

Education – Essential: Master’s Degree

Education – Nonessential: Master’s Degree

Education…