Care Management Supervisor

WVU Medicine

6d•Onsite

About The Position

Promotes the achievement of optimal clinical and resource utilization allocation, facilitates appropriate lengths of stay and reimbursement for all hospital admissions in accordance with goals and objectives. Acts as a key informational and educational resource liaison for the team. Works to develop organizational approaches to problem-solving. Analyzes current systems and variances to identify opportunities for improvement. Works to promote quality of care through collaboration with all service team members, patients, and families.

Requirements

Bachelor’s Degree in Nursing or Master’s Degree in Social Work
Must possess current licensure as required by state board where services will be provided: Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC)
Licensed Graduate Social Worker (LGSW) through the West Virginia Board of Social Work
Licensed Certified Social Worker (LCSW) through the West Virginia Board of Social Work
Licensed Independent Clinical Social Worker (LICSW) through the West Virginia Board of Social Work
Five (5) years of Nursing or Medical Social Work experience (two (2) of which are inpatient hospital setting).
Two (2) years of Care Management or supervisory experience.
Working knowledge of regulatory requirements and insurance coverage/limitations as it relates to care delivery in the acute setting and transitioning to the non-acute setting.
Possesses excellent interpersonal communication and negotiation skills in interactions with patients, families, physicians, and healthcare team colleagues.
Ability to work with people of all social, economic, and cultural backgrounds and be flexible, open minded, and adaptable to change
Demonstrates expert team building skills, problem solving abilities, and conflict resolution strategies

Nice To Haves

Care Management Certification.

Responsibilities

Oversees the discharge/transition planning executed by the Care Management staff, and audits said activities for accuracy of delivery.
Conducts weekly Clinical-Financial meetings to monitor patients with high dollar, high LOS and/or social barriers. Collaborates with multidisciplinary team to problem solve for these cases.
Participate in weekly meetings with new employees and Preceptor during orientation phase to evaluate the staff progress and adjust plans accordingly.
Demonstrates clinical expertise by serving as a resource and role model for department personnel.
Provides guidance on complex high acuity patient assessments and interventions, and intervenes accordingly.
Provides timely and comprehensive documentation of interactions with patients/families.
Assists departmental executive leadership team in the development of annual competency analysis system requirements and criteria to assure knowledge, skills and attitudes that are necessary to fulfill role expectations in the institution.
Provide constructive and timely feedback to Manager on employee performance and management.
Supports an environment for innovation, creativity and empowerment with care delivery based on current literature and research.
Promotes and contributes positively to intradepartmental and interdepartmental relationships.
Serves as role model and promotes within the staff effective communication and conflict resolution skills, reflecting quality service attitudes and keeping consumer satisfaction in mind.
Performs monthly compliance audits as directed.
Serves on various hospital committees as needed or assigned.
Educates hospital staff and physicians to payer regulations and managed care principals to ensure seamless patient care.
Fosters the integration of staff and/or students into the healthcare team.
Improves and maintains management skills by participating in self-development activities such as seminars, workshops, classes and literature review.