Manager, Acute Complex Care

ChenMed•Tampa, FL

7d•$91,165 - $130,235•Hybrid

About The Position

The Manager, Acute Complex Care is a regional leadership position, accountable for the direction, leadership and support of our Acute Care Team, Acute Care Supervisors, and Acute Care Managers in delivering the day-to-day programmatic acute care strategy. The incumbent will be responsible for clinical oversight of our care coordination efforts across the continuum of care, ensuring that our patients receive and experience the highest quality of care in acute and post-acute facilities, leveraging all available resources, in line with the ChenMed model and acute standards of care. The success of this role is determined by their team’s management of hospitalized patients to ensure they receive safe and timely discharge to the lowest level of care. The Manager, Acute Complex Care will report to and collaborate closely with Acute and Post-Acute Care leadership to ensure that the clinical needs of our patients are met in all facility-based healthcare environments (acute care) with high quality care and proper utilization of healthcare resource. This role will collaborate closely with facility-based healthcare providers (acute care providers, case, and utilization management departments), local payor partners and our PCP-led care teams to ensure the patient’s progression through the continuum of care its effective, efficient, equitable, safe and achieves the desired clinical outcomes with effective resource utilization. This position is also responsible for any delegations of case and disease management from one or more health plans. In this capacity, they are responsible for maintaining a program that is consistent with National Clinical Quality Association standards and passes regular Medicare and health plan audits.

Requirements

A valid, active Registered Nurse (RN) license in State of employment plus one of the following degree conditions is required: Bachelor’s Degree in Nursing (BSN); OR Associate degree in Nursing (ADN) with 5 years of recent experience in an acute or post-acute healthcare facility, case management or discharge planning work experience; OR Bachelor’s degree in a health-related discipline
Compact license required if available in state
Minimum five (5) years of care management experience
Minimum two to three (2-3) years nursing leadership/management experience is required in an acute, post-acute care facility or primary care coordination setting
Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment
Strong interpersonal and communication skills and the ability to work effectively with a wide range of internal and external stakeholders
Critical thinking skills required and ability to work independently and as part of a collaborative team
Leadership skills to direct others toward objectives that contribute to the success of the team, region and ChenMed
Ability to cope with stressful situations, manage multiple and sometimes conflicting priorities simultaneously
Understands and is committed to maintaining highest level of confidentiality and patient care standards
Flexibility with schedule, including off-shifts, weekends and holidays to meet the needs of patients, families or staff
Knowledge of the standard operating procedures of care coordination, length of stay management and readmission mitigation
Understanding of case and utilization management procedures in acute and post-acute care settings and how to leverage with inpatient staff for possible reduction of medical cost on long length of stay
Understanding of different levels of care throughout the continuum of acute care
Basic understanding of healthcare economics, cost drivers for Medicare Part A, B and D and cost mitigation strategies; understanding of Managed Medicare guiding principles
Ability to monitor, assess and record patients’ progress and adjust and plan accordingly
Ability to plan, implement and evaluate individual patient care plans
Knowledge of nursing and case management theory and practice; patient care charts and histories; clinical and social services documentation procedures and standards
Knowledge of community health services and social services support agencies and networks
Ability to communicate technical information to non-technical personnel
Above average proficiency in Microsoft Office Suite products including Excel, Word, PowerPoint, and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
Ability and willingness to travel locally, regionally, and nationwide up to 30% of the time or onsite at a hospital setting for co-location efforts
Spoken and written fluency in English, bilingual preferred
This job requires use and exercise of independent judgment

Nice To Haves

BA/BS degree in Healthcare Administration or a closely related field, preferred
Master’s degree a plus
Training and experience in using operational and quality improvement skills including – lean, process improvement preferred
Leadership experience in a healthcare setting working with health plans, specialists, hospital providers, and post-acute providers, including hospital, skilled nursing facilities, home health, behavioral health, social service, and other agencies
Current, relevant, and substantial knowledge of areas related to medical cost, quality and value, and other clinical issues, especially within a managed care environment required

Responsibilities

Manages a multi-market team of Acute Complex Managers Acute Complex Care in the day-to-day execution of our acute care coordination effort as well educating HCM’s on these standards.
Ensures daily presence of team members at assigned hospitals during core hours or as determined by team workflow and that team maintains a balanced caseload.
Actively involved in the full employment cycle of direct reports, including but not limited to: participation in the recruitment process, talent and performance management, day-to-day oversight of staffing/scheduling needs, weekly time, time off approval, team vacation coverage plan, active nursing license verification, problem solving, exit interviews and termination/counseling decisions.
Supports, collaborates and partners with the Complex Care and Clinical Strategy Teams on the day-to-day execution of our acute care standard operating procedures as well educating and ensuring that Acute Care Managers deliver on these standards.
Accountable for the overall performance and delivery of all Complex Care key performance indicators related to acute care management.
Ensures direct reports retain their active nursing license as appropriate.
Educates acute care management teams on appropriate levels of care in the hospital (ER only vs inpatient vs observation status) and post-acute setting (HHA, SNF, IRF, LTAC, Hospice Care) in accordance with industry standard and federal and local guidelines.
Ensures acute care management teams understand the key performance indicators and have all the necessary tools and resources to effectively deliver expected outcomes.
Ensures accountability to the daily presence in assigned acute facilities of the Acute Care Manager.
Supports and educates the acute care team on identifying and managing safety risk (complete a social assessment), functional status (ADLs and PT needs), discusses medications and self-management at the acute facility bedside, identifies and corrects knowledge deficits.
Implements and supervises the Acute Care Managers (HCMs) Coaching Program.
Ensures team has all available resources and knowledge to execute on overall length of stay mitigation that results in safe and effective discharge process to the next proper level of care.
Ensures teams can identify from day one (1) of hospital stay any barriers for a safe discharge back to the community and executes on the standards operating procedures to achieve readmission avoidance.
Supports the care coordination of patients in post-acute care facilities (SNF, IRF, LTACH) in close collaboration with post-acute physician and/or Regional Medical Director and ensures a safe and effective transition to a lower level of care as soon as appropriate using a preferred provider network if further services are needed taking into account a proper allocation of resources.
Seeks assistance from ChenMed’s Specialty and Network Teams when needed to support the care of our patients in healthcare facilities.
Assists with creation and implementation of SOPs as requested by Complex Care COE.
Participates in surveys, studies, quality improvement initiatives and special projects as assigned by leader and requested by ChenMed and/or Complex Care COE.
Assists with coverage for PTO and open positions as requested.
Serves as a preceptor when assigned.
Closely supports field and regional teams delivering care within the programs scope of practice for Acute Care Managers.
Ensures high quality candidates are hired and onboarded in accordance with ChenMed and Complex Care COE standards.
Provides structure, process and mentoring in the consistent implementation of acute care standards with SOPs and policies across all ChenMed cities.
Leverages technology and data to performance manage, improve results, and team effectiveness.
Identifies gaps and recommends enhancement related to new and/or existing technology, processes, and existing products and/or services based on feedback and experience from acute care team members.
Ensures all operating processes are compliant and executed at the highest standards of service excellence.
Assists with quality audits and data analyses to identify opportunities for improvement.
Performs other duties as assigned and modified at manager’s discretion.