Program Manager Care Management - Case Management

About the role

The Care Management Program Manager is responsible for the oversight and optimization of patient flow and the communication and documentation among stakeholders related to discharge readiness and planning of patients in the hospital. Stakeholders include, but are not limited to, the physician, nursing, ancillary team members, local hospital leadership, and the care management department. The Program Manager acts as the central point of contact for collaborating throughout the hospital to remove discharge barriers and mitigate potential delays in care. The role also compiles and tracks data related to discharge barriers to evaluate the need for systemic workflow changes, monitors the effectiveness of solutions to manage and reduce length of stay, and enhances access to care from the community. Additionally, the Program Manager provides education to hospital departments on throughput and medical necessity and pursues process improvement and organizational development opportunities.

Responsibilities

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Oversees and optimizes patient flow within the hospital.
• Identifies and addresses bottlenecks helping to ensure timely transitions and discharges.
• Works with and participates in educating physicians and other clinical associates regarding clinical guidelines for medical necessity.
• Evaluates, monitors, and improves throughput via metrics as it relates to discharge planning.
• Drives length of stay reduction and optimization by identification and mitigation of discharge and throughput barriers.
• Monitors patient flow data to identify areas for improvement and implements strategies to optimize patient care delivery.
• Ensures optimal bed utilization and availability.
• Coordinates exchange of information and communication related to care needs, discharge barriers, and throughput challenges among hospitalist and other physician groups, nursing and nursing administration, Emergency Department personnel, Care Management, and other ancillary departments.
• Prepares for daily morning huddle by identifying written discharge orders and notifies appropriate teams when discharge orders are present.
• Attends daily afternoon physician rounds.
• Tracks patients in observation status and escalates to appropriate associates when an opportunity for conversion to inpatient or for discharge is identified.
• Identifies and records avoidable delays in the EMR.
• Follows established escalation protocols for delays in discharge and care delivery delays.
• Demonstrates the ability to communicate effectively, expresses ideas clearly, actively listens and follows appropriate channels of communication.
• Demonstrates clinical competency ability to collaborate with others; ability to initiate and plan own work activities.
• Participates in the strategic planning activities of the department.
• Demonstrates strong interpersonal skills, handles conflict constructively.
• Participates in interdisciplinary committees within the hospital and special projects.
• Demonstrates good judgment in problem solving, communicates unresolved problems to appropriate personnel.
• Demonstrates familiarity with evidence‑based medical necessity criteria sets.
• Follows the CHRISTUS Health Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected Health Information (PHI).

Qualifications

• Education in nursing, social work, or other applicable health‑care concentration (required).
• Three or more years of experience in case management, preferably in the acute‑care setting (required).
• Licensure in nursing, social work, or other applicable health‑care field to practice in the state of employment (or compact) (required).
• Certification in Case Management (preferred).

Schedule

8 AM – 5 PM, Monday‑Friday (Full‑time).