Clinical Case Management Manager

The University of Kansas Health System•Kansas City, KS

About The Position

The Clinical Case Management Manager is responsible, under the direction of the Director of Case Management or Director of Continuum of Care and in collaboration with hospital leadership, for daily operational management of the Case Management teams, including staff orientation and ongoing development. The role plans, directs, and oversees Case Management/Continuum of Care at The University of Kansas Hospital. The manager advocates for individuals, families, communities, and populations; supports their involvement in care and access to personal health information; and promotes coordinated, efficient care. The role works with physicians, nursing and ancillary staff, interdisciplinary teams, leadership, and other stakeholders to improve care delivery and discharge planning. It develops or recommends policies, procedures, programs, and processes that improve quality, efficiency, effectiveness, and satisfaction for patients, physicians, and payers. The position requires knowledge of Medicare and Medicaid regulations and admission and continued-stay medical necessity criteria. The manager maintains current professional knowledge and competency, evaluates practice against relevant standards and regulations, integrates ethical provisions into practice, and contributes to the professional development of peers and colleagues. The manager must be able to perform the professional, clinical, or technical competencies of the assigned department. Duties may vary by department or unit, and other duties may be assigned.

Requirements

Bachelor’s degree in Nursing or Master of Social Work.
At least 5 years of clinical nursing or healthcare experience.
At least 2 years of case management or care coordination experience.
Licensed Master Social Worker (LMSW) from the State Board of Behavioral Sciences upon hire, or Licensed Registered Nurse (LRN), Multi-State, from the State Board of Nursing upon hire.
Basic Cardiac Life Support (BLS or BCLS) certification from the American Heart Association.
Knowledge of Medicare and Medicaid regulations.
Knowledge of admission and continued-stay medical necessity criteria.

Nice To Haves

Master’s degree in Nursing.
Managed care experience.
Nursing Case Management Certification (CMGT-BC) from the American Nurses Credentialing Center (ANCC).

Responsibilities

Manage daily operations of the Case Management teams, including staff orientation and ongoing development.
Plan, direct, and oversee Case Management/Continuum of Care at The University of Kansas Hospital.
Advocate for the protections and rights of individuals, families, communities, and populations, and support their involvement in care and access to personal health information.
Collaborate and coordinate with physicians and department management to improve coordinated care and eliminate barriers to efficient care delivery.
Collaborate with nursing and ancillary staff at all levels, interdisciplinary teams, leadership, and other stakeholders.
Work with physician leadership to strengthen physician involvement in discharge planning.
Develop and recommend policies, procedures, programs, and processes to improve quality, efficiency, effectiveness, and patient, physician, and payer satisfaction.
Maintain current knowledge and competency through experience, independent learning, professional records, and use of research and other evidence.
Evaluate practice against professional standards, guidelines, statutes, rules, and regulations; obtain feedback and take action to improve performance.
Integrate ethical provisions into all areas of practice.
Contribute to the professional development of peers and colleagues by sharing knowledge and skills.
Perform the professional, clinical, or technical competencies required by the assigned department or unit.