Manager, Case Management - Hospital Onsite

Med-Metrix•New York, NY

56d•Onsite

About The Position

The Manager, Case Management is responsible for the day-to-day management of the Case Management department. This includes, but is not limited to supervision of staff, staff assignment/productivity, staff recruitment, retention, daily staffing, employee performance evaluation, performance improvement and education. The Manager, Case Management serves as a resource/mentor for Case Managers, Social Workers and other medical and hospital staff, and participates in the development and implementation of new initiatives that support excellence in patient experience and drive efficiency and efficacy of the case management operations. The Manager, Case Management reports to and assists the Directors of Case Management and Social Work.

Requirements

BSN, Master’s degree in nursing or health related field, including LCSW
Experience with Case Management software desired (CarePort/Wellsky/MCG/etc.)
Ability to adapt to a fast-paced and changing environment, managing multiple priorities and deadlines effectively
Advanced proficiency in Microsoft Office Suite, including experience in Excel financial modeling and analysis
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required
Gracious and welcoming personality for customer service interaction
Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.

Responsibilities

Develop, implement and maintain professional standards
Serve as a clinical resource and lend guidance to staff in utilization management, discharge planning, and care coordination issues
Provide operational and clinical oversite to ensure that all day-to-day activity supports optimum patient throughput and excellent patient care
Demonstrate integral involvement in the quality improvement activities of the case management department
Work with the case managers, clinical nurse managers, physicians, and social work to facilitate Interdisciplinary Rounds to ensure compliance with the patient treatment plan
Facilitate patient flow and monitor length of stay for each patient; Meet with Case Managers and Social Workers to review medically complex and long stay cases and refer to physician advisors as required
Collaborate with the Directors of Case Management and Social Work to maintain, review and update all policies in accordance with hospital, professional and regulatory standards
Create and maintain an environment of care where patients, families, staff and others are treated with respect, dignity and in a professional manner, promoting an environment respectful of cultural diversity
Attend interdisciplinary rounds as necessary
Regularly review avoidable day, excess day and denial data for follow-up and development of process improvement actions as necessary
Ensure UM deliverables are met such as timely admissions and continued stay reviews
Coordinate activities to maintain patient throughput and facilitate the flow of information from other departments to staff
Evaluate staff performance and productivity on an ongoing basis and complete staff performance appraisals in a timely manner. Provide recognition of exemplary employee performance and also provide employee counseling / progressive discipline as necessary.
Coordinate staff meetings
Encourage and facilitate professional growth and development of staff
Promote a positive environment that encourages staff to participate in the identification of areas of opportunity for improvement in length of stay, throughput and appropriate level of care
Ensure that personnel issues are managed in compliance with contractual agreements and supports positive employee-management relationships
Ensure all personnel are appropriately licensed, credentialed, competent and complete ongoing/annual educational programs as required
Communicate information thoroughly and compose and distribute daily, weekly, and monthly reporting as needed
Input data into the computer systems accurately relevant to all Case Management activities, Utilization Review and other items managed by the Case Management department
Maintain electronic and manual files of all Case Management activities, process improvement initiatives and results
Forward information to other departments as indicated
Utilize various systems to track and report on departmental activity
Manage and review patient cases for accuracy and completeness without compromising quality in entering area specific information
Adhere to required timeframes and deadlines for reporting and work requirements
Effectively identify and communicate barriers preventing accurate data entry and report generation to leadership
Manage the Case Management tracking system(s) and reporting functions
Request medical records for retrospective reviews from the Health Information Management department
Other duties as assigned
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties