Care Management - Manager - Supervisor Experience in a Hospital Setting Required

Orlando Health•Orlando, FL

7d•Onsite

About The Position

Leads the care management team in facilitating appropriate use of hospital resources and effective discharge planning and coordination of services to transition patients to the next appropriate level of care. This role requires onsite acute-care experience, compassion, and empathy for patients. The manager oversees educational, financial, and human resources for the care management teams, supporting high-quality, cost-effective, responsive, patient-focused services. The role coordinates staffing and workload distribution, builds relationships with hospital and community stakeholders, supports payer relationships and reimbursement, monitors utilization measures, and leads performance-improvement and population-health initiatives. The position also oversees regulatory education and compliance, budget implementation, service-problem resolution, incident-report follow-up, staff meetings, and human-resources functions. It facilitates physicians and nursing staff on utilization and discharge planning, care coordination, and utilization-management issues; maintains confidentiality and policy compliance; and provides dashboard statistics on team effectiveness.

Requirements

Formal leadership experience required.
Graduate of an approved school of nursing, or a master’s degree in Social Work (MSW), Mental Health Counseling (MHC), or Marriage and Family Therapy (MFT), required.
Three years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care required.
Acute-setting supervisory experience overseeing a minimum of 20 team members is required as stated in the qualifications.
Florida RN license required and must be maintained current for graduates of an approved school of nursing.
BLS/Healthcare Provider certification required.
Knowledge of hospital and department policies and procedures and regulatory requirements relevant to care management.
Ability to compile, analyze, and interpret data and use spreadsheet, graphics, database-management, and word-processing software.
Knowledge of labor and expense budgets, revenue, and census projections and development.
Ability to maintain confidentiality.

Nice To Haves

RN or MSW highly preferred.
Medical experience preferred.
Two years of utilization-management experience preferred.

Responsibilities

Manage educational, financial, and human resources for care management teams.
Coordinate workload distribution and scheduling to ensure appropriate staffing for patients and families across the Orlando Health network.
Develop collaborative relationships with site leadership, medical staff leadership, managed care contractors, and community leaders.
Support positive payer relationships and develop plans to optimize reimbursement and quality of care.
Monitor working DRGs and GMLOS assignments as appropriate.
Implement performance-improvement processes, including outcome measurement and identification of strategies and opportunities that promote population health.
Develop strategies to manage patient care across the continuum, focusing on high-risk, high-cost, and problem-prone areas, including readmission risk.
Support clinical quality and cost-improvement initiatives and efforts to prevent rehospitalizations.
Develop recommendations to integrate post-acute care services with hospital operations.
Design educational strategies to support compliance with applicable NCQA, HIPAA, CMS, and other regulatory standards.
Coordinate budget implementation for payroll, supplies, and other functions affecting departmental financial performance.
Serve as a department intermediary for service problems.
Ensure incident reports are completed appropriately and follow up as needed.
Organize and lead staff meetings and huddles.
Promote and communicate change.
Maintain professional proficiency and involvement in professional organizations and continuing education.
Hold self and others accountable to Orlando Health’s mission, vision, and values.
Develop and recommend concepts for new business opportunities, subsidiary organizations, acquisitions, business design, or organizational structure.
Manage human-resources functions, including hiring, work assignments, coaching plans, and performance counseling.
Maintain regular and punctual attendance consistent with applicable policies and laws.
Maintain compliance with Orlando Health policies and procedures.
Apply knowledge of hospital and department policies and relevant regulatory requirements.
Compile, analyze, and interpret data, including use of spreadsheets, graphics, database management, and word-processing software.
Facilitate physicians and nursing staff on utilization and discharge planning, care coordination, and utilization-management issues.
Apply knowledge of labor and expense budgets, revenue, and census projections and development.
Maintain confidentiality of data and information.
Provide matrices and dashboard statistics demonstrating the effectiveness of the case-management and care-coordination team.