Patient Care Manager - BSW

Company Description

More Than Just Care, It's Community

Imagine doing meaningful work in a place where people vacation. That's life at Munson Healthcare - northern Michigan's largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties.

If you want a career in healthcare and a lifestyle most people only dream about - with freshwater lakes, scenic trails, charming downtowns, a vibrant arts scene, and endless outdoor adventures - you might just be Munson Material. To us, that means teammates who live by our values of excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for our patients and each other.

Join a team that delivers outstanding care in one of the most beautiful regions in the country.

Invested in You

* Grow:
Tuition reimbursement, in-person and online development, and access to our career hub to help you advance.

* Thrive:
Full benefits, paid holidays, generous PTO, employee discounts, and free individual retirement counseling.

* Be Well:
Free wellness platform for you and your family, plus personalized support for personal or family challenges.

* Be Heard:
Share your ideas and help shape the way we work through improvement huddles, employee surveys, and town hall meetings

Job Description

A Day in the Life

* The Patient Care Manager facilitates progression-of-care; and monitors the patient's progress to ensure that the plan of care and services provided are patient focused, high quality, evidence based, appropriate to patient needs, efficient, and cost effective.

* Has basic understanding of Relationship-Based Care (RBC) principles, meets expectations outlined in Commitment To My Co-workers, and supports RBC unit action plans.

* Uses effective customer service/interpersonal skills at all times.

* Maintains working knowledge/experience in utilization management, managed care, and payer issues that may impact the course of care.

* Timely response to screening referrals for case management services.

* Ability to identify appropriate community resources on assigned caseload and to work collaboratively with patients, families, and multidisciplinary team and community agencies to achieve desired patient outcomes.

* Confirm admission diagnosis and identify related quality/care metrics to promote medical compliance.

* Advocate for patient by assessing that patients healthcare needs are being addressed in the most appropriate level of care.

* Encourages and facilitates patient/family participation in all care and treatment decisions.

* Educates members of the patient's healthcare team on the appropriate access to, and use of various levels of care.

* Identifies patients at risk for readmission and refers them for community based follow up. Recognizes and responds appropriately to readmission or psychosocial risk factors.

* Consults with physician advisor as necessary to resolve progression-of-care barriers through appropriate administrative and medical channels.

* Serves as primary liaison between and among physicians, patients, families, payers, external case managers and interdisciplinary clinical team.

* Participates in discharge planning activities for complex patients, in order to ensure a timely discharge and to provide appropriate linkage with post-discharge care providers. Refers appropriate cases to the Complex Discharge planner.

* Collaborates with Post-Acute Coordinators to monitor and facilitate the progress of completing complex post-acute services.

* Interface with utilization review specialists to stay current on patient's eligibility for admission, continuing stay or readiness for discharge according to medical necessity guidelines. (Inter Qual criteria)

* Persevere in attempts to influence clinical and financial outcomes of care. Identify and record episodes of preventable delays or avoidable days due to failure of progression-of-care processes.

* Participates in quality improvement plan activities and any other departmental research or studies as requested by the department manager.

* Assertively manage resource utilization while appropriately navigating the patient's movement along the continuum of care.

* Collaborate with social workers, counselors and Resource Center coordinators to research discharge placement options, when home discharge is not possible, while continuing to focus on patient/family goals, interdisciplinary team recommendations, available payer benefits and private financial considerations which may impact placement.

* Utilizes the Program Manager, Director and Medical Advisor as expert advisors to gain insights in dealing with physicians and Resource Management issues.

* Works with resource center and providers to determine patient's eligibility for post-acute services.

* May assist in training and orientation of new department employees and students. Performs other duties and responsibilities as assigned.

Qualifications

What's Required

* Bachelor's Degree in Nursing or Social Work.…