Manager Care Management

University of Maryland Medical System•Largo, MD

9d•Onsite

About The Position

The Manager, Care Management is responsible for the operations of the assigned areas to include care management, discharge and transition planning, and utilization management in accordance with all regulatory requirements and the needs of the hospital. Ensures optimal clinical and financial outcomes across provider lines and systems in conjunction with all members of the healthcare team.

Requirements

Bachelor’s of Science in Nursing OR Masters of Social Work required
Licensure as a Registered Nurse in the state of Maryland or Licensed Clinical Social Worker (LCSW) OR Licensed Certified Social Worker – Clinical (LCSW-C)
Three (3) years of previous case management experience
Two (2) years previous supervisory experience

Responsibilities

Regularly observes the performance of team members to evaluate efficiency, skill, abilities, and attitudes in the workplace toward others and patients/customers. Recommends corrective actions and completes performance evaluations. Maintains a consistent environment where employees are encouraged, reinforced, and supported in their desire to contribute.
Maintains ongoing communication with staff to maintain institutional and departmental goals and encourages staff participation and communication in decision-making.
Monitors reasons for reduction in patient satisfaction, re-admission and discharge appeals and reports trends to the leader.
Makes recommendations for transfers, promotions, and training to ensure the effective utilization of individual skills and employee development. Performs in-service education and develops team members. Maintains knowledge base to present accurate/current information.
Serves as a resource for the staff providing expertise and guidance with regard to clinical activities.
Participates in meetings and provides updates on regulatory changes, process changes, problem identification and other appropriate matters.
Participates in the development, revision, implementation, and communication of policies and procedures and standards for the staff in accordance with hospital and department policies and procedures
In collaboration with the leader, maintains an effective, organized care management and utilization review programs and other interdepartmental programs that assure compliance with federal and state regulatory policies for hospital services of various regulatory agencies (PRO, Joint Commission, CMS and Department of Health and Mental Hygiene).
Assists with the development of goals and objectives consistent with the hospital’s mission and vision.
Prepares and coordinates department activities. Negotiates with diverse groups of people in an exchange of information to provide regular reports.
Responsible for oversight of day-to-day operational procedures and personnel related to data collection, patient through-put, and discharge planning. Creates and develops trend reports and collaborates with leadership to analyze and presents findings.
Assist with administrative planning and program development activities.
Monitors activities related to internal and external customers to achieve optimal customer relations while trying to assure reimbursement for hospital services.
Demonstrates a comprehensive understanding of the organization’s mission, strategic goals, and how their role contributes to the broader vision.
Accountable for delivering high-quality service to all customers, ensuring compliance with regulatory standards, and driving continuous performance improvement.
Effectively manages departmental resources to optimize operations, ensuring efficient and responsible allocation.
Leads the development and administration of annual operating and capital budgets, aligning fiscal planning with organizational priorities.
Provides strategic leadership in human resource management, including workforce planning, staff development, effective communication, and the promotion of a positive and engaged work culture.
Demonstrates strong leadership aligned with the organization’s values and strategic direction.
Utilizes clear, respectful, and professional communication; actively discourages misinformation and promotes transparency. Keeps senior leadership informed of critical updates.
Commits to ongoing professional development and self-directed learning. Upholds confidentiality, professionalism, and accountability in all interactions and decisions. Supports and implements organizational policies.
Maintains productive and collaborative relationships with medical staff, fostering mutual respect and cooperation.
Works effectively as part of a team, demonstrating a commitment to team goals and shared success.
Navigates change with flexibility and adaptability, supporting staff and organizational transitions with resilience.
Applies critical thinking and proactive problem-solving to identify challenges and implement effective solutions independently.
Consistently models integrity, perseverance, and ethical leadership, setting a standard for excellence within the organization.