Manager - Care Management - St. Elizabeth Youngstown Hospital

Bon Secours Mercy Health • Youngstown, OH

20h

About The Position

The Manager, Care Management oversees the day-to-day functions and resources of the Care Management Department at St. Elizabeth Youngstown Hospital. The role combines clinical and financial responsibilities to support strong patient outcomes and organizational performance, and works with Care Management leadership and colleagues to standardize practices and processes.

The manager leads the Care Management team, monitors performance using qualitative and quantitative data, and addresses barriers to improve outcomes. The role promotes appropriate care, effective progression of care, utilization management, and safe, timely transitions across the care continuum. It works closely with nursing, physicians, ambulatory and post-acute providers, population health and community health teams, and other organizational partners.

The position also supports departmental goal-setting and strategic planning, manages personnel resources, participates in budget development and management, identifies cost reductions, and considers the financial impact of contracts and payment models, including the shift from fee-for-service to value-based care.

Requirements

• Bachelor of Science in Nursing or Social Work.
• BLS Basic Life Support certification from the American Heart Association.
• Active RN license or Social Worker license in the state of practice.
• Three years of recent acute hospital care management experience.
• Skills in care management, discharge planning, patient advocacy, flexible care planning, and care coordination.
• Ability to analyze data or information and knowledge of reimbursement methodologies, staffing workflow, bed allocation, and clinical practices.
• Working knowledge of local and state resources and knowledge of government and non-government payer practices, regulations, standards, and reimbursement.
• Leadership, mentorship, employee training, and knowledge-sharing skills.
• Attention to detail, critical thinking, communication with family members, conflict resolution, and a proactive approach.

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 the 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, predictive readmission tools and interventions, denial prevention, progression of care, barrier tracking, daily team rounding, care transitions, and patient satisfaction related to transitions.
• Monitor qualitative and quantitative data, take action to address barriers, and improve outcomes.
• Advocate for and educate stakeholders about providing the right care, at the right time, in the right place.
• Educate care management staff, physicians, nurses, and other care team members on progression of care, level of care, and safe and timely transition management.
• Support national care management standards covering education, care coordination, compliance, transition management, and resource utilization.
• Use departmental systems to support proactive care management across the continuum, aligning 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 line with patient and ministry needs.
• Assist with developing annual departmental goals and objectives aligned with system Care Management goals, and assist with strategic plans and initiatives.
• Build collaborative partnerships with nursing, quality, hospitalist, physician advisor, and other physician leadership to support clinical integration and high-quality, cost-efficient care.
• Participate in developing and managing the annual budget and identify and achieve cost reductions.
• Work with organizational colleagues to standardize operations and collaborate with staff and stakeholders to reduce costs.
• Understand the financial impact of contracts and changing payment models, including 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager