Manager - Care Management - St. Elizabeth Youngstown Hospital
About The Position
The Manager, Care Management is responsible for day-to-day oversight, coordination, organization, and management of the Care Management Department’s functions and resources. The position works with Care Management leadership and colleagues to standardize assigned functions and responsibilities, combining clinical and financial considerations to achieve the best possible outcomes for patients and the organization. The manager leads the Care Management Team’s daily operations and supports effective care management across the continuum. This includes advancing care planning, length-of-stay management, readmission prevention, denial prevention, care progression, daily team rounding, and safe, timely care transitions. The manager monitors qualitative and quantitative data, addresses barriers, and provides education to care management staff, physicians, nursing, and other care team members. The role collaborates with ambulatory and post-acute providers, population and community health teams, physician leadership, nursing, quality, and other stakeholders. It partners with a physician leader on the Utilization Management Committee and uses data and analytic tools to identify utilization opportunities. The manager also directs staffing and resource use, helps set departmental goals and strategic plans, participates in annual budget development and management, and works to reduce costs and standardize operations.
Requirements
- Bachelor of Science in Nursing or Social Work.
- BLS Basic Life Support certification from the American Heart Association.
- RN license or Social Worker license in the state of practice.
- Three years of recent acute hospital care management experience.
Nice To Haves
- Master’s degree in Nursing, Social Work, or Healthcare Administration (preferred for BSMH; required for RSFH).
- Accredited Case Manager (ACM) certification from the American Case Management Association, Certified Case Manager (CCM) certification from the Commission for Case Manager Certification, or ANCC Nursing Case Management board certification.
- Social Worker license preferred in Virginia.
Responsibilities
- Lead and oversee day-to-day operations of the Care Management Team.
- Work with Care Management leadership and colleagues to standardize practices and processes for advance care planning, length-of-stay management, readmission prevention, denial prevention, care progression, daily team rounding, and care transitions.
- Monitor qualitative and quantitative data, address barriers, and take action to improve outcomes.
- Advocate for and educate staff and care team members about appropriate care, level of care, progression of care, and safe and timely transitions.
- Support care management standards covering education, care coordination, compliance, transition management, and resource utilization.
- Use departmental systems to support proactive care management across the continuum and align with population health and community health efforts.
- Collaborate with ambulatory and post-acute providers and staff to support seamless transitions of care.
- Partner with a physician leader to optimize the Utilization Management Committee and provide actionable data about utilization opportunities.
- Direct daily operations and personnel resources in accordance with patient and ministry needs.
- Assist with developing annual departmental goals and objectives aligned with system goals, and assist with strategic plans and initiatives.
- Build collaborative partnerships with nursing, quality, hospitalists, physician advisors, and other physician leaders to support clinical integration and high-quality, cost-efficient care.
- Participate in development and management of the annual budget, identify and achieve cost reductions, and work with colleagues and stakeholders to reduce costs.
- Understand the financial impact of contracts and the shift from fee-for-service to value-based care.
Benefits
- Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions when eligible.
- Medical, dental, vision, and prescription coverage; HSA/FSA options; life insurance; mental health resources; and discounts.
- Paid time off, parental and FMLA leave, short- and long-term disability, and backup care for children and elders.
- Tuition assistance, professional development, and continuing education support.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
