Manager of Care Coordination

Responsibilities

• Provides day to day management of the RN Care Managers in the department, including Utilization Management, Discharge Planning and Denials and Appeals functions.
• Affirms workflow related to readmission prevention, length of stay and daily review of observation admissions.
• Collaborates with Business Office staff regarding workflow processes and maintains an effective denials management process.
• Oversees general operational aspects such as hiring, training, and evaluating staff.
• Develops and implements workflows, policies, procedures, and audits performance.
• Manages staff functions related to employee selection, on-boarding/orientation, coaching/development, staffing, work assignments, performance management, and goal alignment as guided by hospital policy and procedures and collective bargaining unit agreement (when applicable).
• Develops programs to accurately track and analyze care management data collection process.
• Analyzes data to identify patterns and trends of performance.
• Maintains accountability to hospital, state, and federal regulations and professional standards and evaluates alternate level of care determinations to ensure compliance with regulatory requirements and contractual agreements.

Requirements

• Licensed as a Registered Nurse in New York State
• Bachelor’s degree
• Five (5) years previous case management/discharge planning in an acute care setting or other care continuum experience in a clinical setting
• Knowledge of regulatory requirements related to acute care discharge planning
• PREFERRED – Acute care utilization review experience