Supervisor, Care Management

About the role

At Hackensack Meridian Health, our team members are the heart of what makes us better. We help our patients live better, healthier lives—and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better—advancing our mission to transform healthcare and serve as a leader of positive change.

The Supervisor, Care Management integrates and coordinates utilization management, care coordination, discharge planning functions, and performance improvement activities for all care managers. This role is accountable for oversight of the department's designated team member caseloads and plans effectively in order to meet staffing needs, manage length of stay, promote efficient utilization of resources, and ensure that care meets evidence-based practice standards and regulatory/payor requirements.

Responsibilities

• Facilitates collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement.
• Supervises staff with all care management processes, including length of stay (LOS), throughput, patient flow, and denials and appeals follow-up.
• Applies process improvement methodologies in evaluating team members' documentation.
• Ensures that multidisciplinary rounds and team huddles are occurring.
• Provides direction to the multidisciplinary team as needed in difficult cases.
• Obtains, interprets, and presents metrics related to care management.
• Attends key meetings and presents information about existing case management processes.
• Develops performance improvement plans for care managers, documents performance, and provides feedback; evaluates work and provides recognition for proper and efficient performance.
• Determines areas of opportunity and suggests process improvements.
• Follows HR policies for performance and disciplinary action; responsible for disciplinary action and performance improvement plans when appropriate.
• Participates in departmental preparation for regulatory visits and compliance audits.
• Coordinates/facilitates patient care progression throughout the continuum by working collaboratively with the multidisciplinary team.
• Collaborates with ancillary departments to ensure accuracy of patient demographic and insurance information.
• Assists in the collection and reporting of indicators tracking efficiency of case management processes.
• Uses data to drive decisions and plan/implement performance improvement strategies related to assigned staff, including fiscal, clinical, and patient satisfaction data.
• Collaborates with Physician Advisors/Hospitalists on needs related to Case Management and difficult cases.
• Maintains annual competencies and ensures training and continuing education of the team in applicable platforms (Epic, Xsolis Cortex, BI, Google Suites).
• Assumes responsibility for supervision of other case management care coordination managers in the absence of a Supervisor.
• Performs other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor's degree in Nursing or Master's Degree in Social Work.
• At least 3 years full-time experience in an acute care setting.
• Familiar with hospital resources, community resources, and/or resource/utilization management.
• Care coordination, case management, or discharge planning experience.
• Effective decision-making/problem-solving skills, demonstration of creativity in problem-solving, and influential leadership skills.
• Excellent verbal, written, and presentation skills.
• Moderate to expert computer skills.
• Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms.

Licenses And Certifications Required:

• Registered Nurse (RN) with current New Jersey (NJ) License, or Licensed Social Worker (LSW) or Licensed Clinical Social Worker (LCSW).
• Case Management certification by a nationally recognized organization within 1 year.

Licenses And Certifications Preferred:

• Basic Cardiac Life Support Certificate.