Manager - Care Management - Multiple Locations

Bon Secours Mercy Health • Tiffin, OH

8d

About The Position

The Manager, Care Management oversees the day-to-day functions and resources of the Care Management Department, coordinating with Care Management leadership and colleagues to standardize practices. The position combines clinical and financial considerations to support the best possible outcomes for patients and the organization.

The manager leads department operations and staff, monitors performance using qualitative and quantitative data, and takes action to address barriers and improve outcomes. The role supports patient-centered care management across the continuum, including coordination with ambulatory and post-acute providers to support seamless transitions. It also partners with physician leaders on utilization management, contributes to departmental planning and budgeting, identifies cost reductions, and supports consistent operations aligned with system goals.

Requirements

• Bachelor of Science in Nursing or Social Work.
• Three years of recent acute hospital care management experience.
• For RSFH, a master's degree in Nursing, Social Work, or Healthcare Administration is required.
• 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, and bed allocation.
• Clinical knowledge, tracking skills, and working knowledge of local and state resources.
• Knowledge of government and non-government payor 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).

Responsibilities

• Lead and oversee the day-to-day operations of the Care Management team.
• Work with Care Management leadership and colleagues to standardize processes for advance care planning, length-of-stay management, readmission prevention, use of predictive readmission tools, denial prevention, progression of care, avoidable-day tracking, team rounding, care transitions, and patient satisfaction related to transitions.
• Monitor qualitative and quantitative data, address barriers, and improve outcomes.
• Advocate for and educate others 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, timely transitions.
• Support national care management standards for 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 ensure seamless transitions of care.
• Partner with physician leaders to optimize the Utilization Management Committee and provide actionable data on utilization opportunities.
• Direct daily operations to use personnel resources effectively in line with patient and ministry needs.
• Assist with developing annual departmental goals and objectives aligned with system Care Management goals.
• Assist with developing strategic departmental 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.
• Collaborate with organizational colleagues to standardize operations and work with staff and stakeholders to reduce costs.
• Understand the financial impact of contracts and the shift from fee-for-service to value-based care.
• Perform other job-related duties as required by the supervisor, subject to reasonable accommodation.

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. Benefits may vary based on market and employment status.

What This Job Offers

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