Manager for Case Management- Bayview Location

Principal Duties and Responsibilities

• Ensures adequate staffing coverage of all areas of responsibility by monitoring staffing needs, preparing schedules and approving leave requests, and arranging for coverage when staff are absent.
• Captions with the Manager Utilization Management as needed.
• Ensures that policies and procedures are kept current and staff is educated and monitored to be in compliance.
• May coordinate interdisciplinary care for a select caseload of patients from pre-admission through post discharge and taking into consideration the age and development needs of the patient.
• Coaches the case managers by review and ongoing case discussion to develop the optimal safe transition plan taking into account patient and family preferences.
• Evaluates readmissions with the Collaborative Practice Team to identify ways to improve the transition plan with the goal to reduce readmission.
• Attends interdisciplinary rounds routinely on units to identify barriers in transition planning and assist the case manager in addressing those barriers.
• Ensures that the interdisciplinary rounds follow standard work processes and collaborative communication with the team.
• Develops relationships with the medical staff to increase collaboration and ensure open and reliable communication around initiatives and patient care issues.
• Acts as a preceptor for case managers in the onboarding process or oversees the orientation if the preceptor role is delegated.
• Incorporates the principles of reimbursement and managed care strategies into case management services.
• May participate on relevant administrative and clinical committees.
• Safeguards the quality of services rendered by staff.
• Monitors the quality of services rendered by staff.
• Affirms the results of monitoring activities and implements corrective actions for deviations from standards.
• Responsible for effective fiscal management to ensure efficient utilization of financial and material resources.
• Participates in the preparation of the annual budget, monitors expenditures, and completes appropriate reports in a timely manner.
• Participates in leadership activities and special projects pertinent to area of management and as assigned by the Director.
• Reviews and authorizations of charity care.

Required Knowledge, Skills And Abilities

• Work requires the level of knowledge of theories, principles and concepts typically acquired through the completion of a Bachelor’s degree in nursing or a closely related field. Master’s degree is preferred.
• Current MD licensure as a Registered Nurse required.
• Annual Certification in CPR is required. Certification required within 2 years of the position, ACM or CCM.
• Requires 5 years of experience in case management. At least one year of team leader or other leadership experience.
• Knowledge of insurance benefit structures, Medicare Conditions of Participation and regulations.
• Knowledge of utilization management and quality improvement processes.
• Knowledge of outpatient services and settings available.
• Work requires the analytical skills necessary to resolve problems requiring a professional level of knowledge in a specific discipline/field and/or improve, enhance, or upgrade complex clinical, financial, data processing, marketing, or human resources systems and programs.
• Work requires the communication skills necessary to effectively manage the employees within assigned area and to persuade and negotiate with peer-level managers on issues and programs that impact the department.
• Work requires effectively dealing with conflicting views or issues and mediating fair and workable solutions.
• Must complete the Training Checklist for Managers and Supervisors (described in the Training Catalog under Management Development Curriculum) within twelve months of employment/promotion date.