Case Management Manager FT Days

Trane Technologies•Detroit, MI

9h•Onsite

About The Position

DMC Harper University Hospital is a specialty referral hospital recognized for clinical expertise and innovative research, with Centers of Excellence in neurosciences, bariatric surgery, vascular services, multidisciplinary cardiovascular services, hypertension, stroke prevention, and heart failure. The Case Management Manager provides management and operational oversight for the Case Management and Social Work/Discharge Planning departments at assigned DMC hospital(s), in collaboration with hospital and system leadership. The manager ensures consistent, coordinated delivery of assigned processes and oversees day-to-day department operations to support hospital objectives. The role develops and implements personnel education and orientation programs; helps define and update procedures and protocols; monitors staff quality and productivity; approves personnel actions; completes performance appraisals; and ensures staff competency. The manager assists with department goals, measures, budget development and monitoring, and accountability for patient coverage and related staff activities. The manager is accountable for third-party payer communications related to discharge planning and decision-making, and monitors compliance with applicable laws, payer requirements, government regulations, and Joint Commission requirements. The role implements audit recommendations as directed, engages physician advisors to facilitate care decisions when needed, and maintains current knowledge of healthcare practices, case management strategies, payer requirements, and regulatory and compliance obligations. The position also establishes effective relationships with physicians and other internal and external staff, identifies and resolves customer or referring-source concerns, and promotes positive customer relations. Other duties and functions may be assigned.

Requirements

Graduate from an accredited school of Nursing.
Bachelor’s degree in Nursing or another health-related field, or an equivalent combination of education and/or related experience.
Three to five years of clinical nursing experience.
Two years of experience in utilization management, case management, or discharge planning in an acute care setting.
Two years of management experience in an acute care setting.
License to practice as a Registered Nurse in the State of Michigan.

Nice To Haves

Master’s degree preferred.
Previous experience with the targeted patient population preferred.
Case Management certification strongly preferred.

Responsibilities

Provide management and operational oversight for Case Management and Social Work/Discharge Planning departments at assigned hospital(s), in collaboration with hospital and system leadership.
Ensure consistent and coordinated delivery of assigned processes within the hospital.
Manage day-to-day department operations to help accomplish hospital objectives.
Develop and implement education and orientation programs for personnel.
Identify the need for and draft or define procedures and protocols with higher-management input; modify them as necessary.
Monitor staff quality and productivity to ensure work is completed.
Approve personnel actions, including hiring, termination, and discipline.
Complete performance appraisals and ensure staff competency.
Assist with developing daily, monthly, and yearly department goals and measures, and assess goal attainment as requested.
Assist in developing and monitoring the budget and develop current-to-intermediate department goals and measures.
Maintain accountability for patient coverage and related activities among assigned staff.
Maintain accountability for third-party payer communications concerning discharge planning and decision-making.
Monitor activities and ensure compliance with applicable laws, payer requirements, government regulations, and Joint Commission requirements.
Implement internal and external audit recommendations as directed.
Engage physician advisors to facilitate care decisions as needed.
Maintain current knowledge of healthcare practices, case management strategies, payer requirements, and regulatory and compliance requirements.
Establish and maintain effective relationships with physicians and other staff members, internally and externally.
Identify customer or referring-source problems or dissatisfaction and work to resolve them.
Promote positive customer relations and turn negative situations into supportive relationships through concern, poise, understanding, honesty, and tact.
Perform other assigned duties and functions.