Population Health Care Manager- Complex Care Management

Responsible for Complex Care

• Maintain daily census and assignments to ensure all patients are assessed.
• Coordinate and implement timely discharge plans and care transitions across the continuum of care.
• Ensure optimal utilization of patient and system resources.
• Communicate effectively with healthcare team members regarding assessment findings, discharge planning needs, and provider orders.
• Provide education and guidance on specific benefits, reimbursement guidelines, and applicable regulations to providers, patients, and families.
• Collaborate with Utilization Management partners to enhance negotiations and prevent denials from payers.
• Maintain accurate and timely documentation of assessments, discharge arrangements, and actions taken.
• Participate in Quality Assurance/Performance Improvement activities as requested.

Knowledge, Skills and Abilities

• Effective self-direction and problem-solving skills.
• Excellent written and verbal communication skills.
• Basic computer skills necessary.

Level Characteristics

N/A

Minimum Qualifications

• Education: BSN or MSW required.
• Experience: 3 years of relevant experience; Hospital Case Management preferred.
• Degree, Licensure, Certification: Requires Case Management Certification (ACM, CCM or ANCC) within 2 years or of hire. BSN required and must have current or compact RN licensure in state of NC. MSW

Essential Physical Job Functions

Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.