Manager - Care Management - St. Rita's Medical Center

Mercy Health BSMH • Bath Township, OH

1d

About The Position

The Manager, Care Management is responsible for the day-to-day oversight, coordination, organization, and management of functions and resources for the Care Management Department at St. Rita's Medical Center. The role collaborates 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 Care Management operations and staff, promoting effective care progression, utilization, safe transitions, readmission prevention, and patient-centered care across the continuum. The role works with physicians, nursing, ambulatory and post-acute providers, and other stakeholders, and supports departmental goals, strategic plans, budget management, and cost-reduction efforts.

Requirements

• Bachelor of Science in Nursing or Social Work.
• Three years of recent acute hospital care management experience.
• Skills in care management, discharge planning, patient advocacy, care planning, and care coordination.
• Ability to analyze data or information; knowledge of reimbursement methodologies, staffing workflow, and bed allocation.
• Clinical knowledge and tracking skills.
• Working knowledge of local and state resources.
• 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 is preferred for BSMH.

Responsibilities

• Provide leadership 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, medical-necessity denial prevention, progression of care, barrier resolution, avoidable-day tracking, daily team rounding, care transitions, and patient satisfaction related to transitions.
• Monitor outcomes using qualitative and quantitative data, take action to mitigate barriers, and improve results.
• Advocate for and educate staff and care teams about providing the right care, at the right time, in the right place.
• Educate care management staff, physicians, nursing, and other care team members on effective progression of care, level of care, and safe, timely transition management.
• Support national care management standards for education, care coordination, compliance, transition management, and resource utilization.
• Use Care Management Department 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 ensure seamless care transitions.
• Partner with a physician leader to optimize the Utilization Management Committee and provide actionable data about utilization opportunities using qualitative information and analytic platforms such as Quality Advisor and other facility or system resources.
• Direct daily operations to use personnel resources effectively and consistently with patient and ministry needs.
• Assist in developing annual departmental goals and objectives aligned with system Care Management goals, and assist in developing strategic departmental 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 developing and managing the annual budget and identify and achieve cost reductions.
• Work with organizational colleagues to standardize operations and understand the financial impact of contracts and changing payment models from fee-for-service to value-based care.
• Collaborate with staff and key stakeholders to reduce costs.

Benefits

• Competitive pay, incentives, referral bonuses, and a 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