Manager, Case Management

Hollywood Presbyterian•Los Angeles, CA

About The Position

To lead the company to consistently deliver patient centered care that results in the best patient experience in the nation and number one in the nation in safety and satisfaction through the utilization of a collaborative approach to affect a multi-disciplinary tactic to patient care while promoting quality, cost effective outcomes. Supervises Case Management, Utilization Review and Discharge planning activities. Facilitates processes associated with identifying appropriate alternative placements for patients. Facilitates the streamlining of the health care delivery process to focus on the best treatment for the patient, thus minimizing or eliminating unnecessary steps and promoting the timely provision of care and utilization of resources. Oversees case management process as it relates to the patient’s current treatment plan in order to identify barriers to moving the patient through the continuum of care. Acts as primary liaison for coordinating internal DRG review, contracted third party payers, contracts hospice with the assistance of social work and managed care utilization issues. Oversee Throughput activities and ensure timely discharge of patients and/or proper escalation processes. Attend Meetings as necessary and respond to emails timely Monitor productivity and quality of performance for staff report Perform annual evaluations and provide face to face feedback to the team Interact in Polite and Professional Manner with all Customers Work on Strategy and Compliance with Vendors and other outside Partners to prevent conflicts of interest and adequate support for things such as recoup care, hospice, placement, home health, snf, etc. Work closely with hospitalist group and physician to ensure the length of stay and other quality metrics are met and escalate as necessary Demonstrates knowledge and commitment to the organization hospital-wide Performance Improvement Program in order to ensure continuous quality improvement of all processes. Oversees the programs that provide education and consultation to members of the Medical Center health care team to ensure attention to bio psychosocial needs of the patients. Helps lead the company’s effort to earn and retain JC certification and other relevant government programs Be present where needed, ready to work and on time for all work hours, and to recognize when situations require more effort and effective leadership to satisfy the responsibilities of the position in a timely manner

Requirements

Graduate of an accredited RN Nursing Program.
Ability to communicate effectively verbally and in writing.
Must be able to work in a union environment.
Case Management experience in Acute Care Hospital 5 years or more required.
Current California RN license.
Current BCLS card.
Current Los Angeles County Fire Card required (within 30 days of employment).
Assault Response Competency (ARC) required (within 30 days of hire)

Nice To Haves

Bachelor’s Degree in Nursing or related field preferred.
Three years progressive management experience in the field of expertise.
Case Management certification

Responsibilities

Supervises Case Management, Utilization Review and Discharge planning activities.
Facilitates processes associated with identifying appropriate alternative placements for patients.
Facilitates the streamlining of the health care delivery process to focus on the best treatment for the patient, thus minimizing or eliminating unnecessary steps and promoting the timely provision of care and utilization of resources.
Oversees case management process as it relates to the patient’s current treatment plan in order to identify barriers to moving the patient through the continuum of care.
Acts as primary liaison for coordinating internal DRG review, contracted third party payers, contracts hospice with the assistance of social work and managed care utilization issues.
Oversee Throughput activities and ensure timely discharge of patients and/or proper escalation processes.
Attend Meetings as necessary and respond to emails timely
Monitor productivity and quality of performance for staff report
Perform annual evaluations and provide face to face feedback to the team
Interact in Polite and Professional Manner with all Customers
Work on Strategy and Compliance with Vendors and other outside Partners to prevent conflicts of interest and adequate support for things such as recoup care, hospice, placement, home health, snf, etc.
Work closely with hospitalist group and physician to ensure the length of stay and other quality metrics are met and escalate as necessary
Demonstrates knowledge and commitment to the organization hospital-wide Performance Improvement Program in order to ensure continuous quality improvement of all processes.
Oversees the programs that provide education and consultation to members of the Medical Center health care team to ensure attention to bio psychosocial needs of the patients.
Helps lead the company’s effort to earn and retain JC certification and other relevant government programs
Be present where needed, ready to work and on time for all work hours, and to recognize when situations require more effort and effective leadership to satisfy the responsibilities of the position in a timely manner