Mgr Care Management Acute - Care Management and Services

Kettering Health Network•Hamilton, OH

About The Position

The Acute Care Management Manager provides staff oversight, direction and leadership across service areas by functioning as a technical, clinical, and procedural resource for day-to-day operations. The manager evaluates the departments performance and recommends and implements process improvements through an analysis of efficiencies and opportunities while working closely with Network Care Transitions and Post-Acute Care Management, Network Clinical Quality, and Network Utilization Review departments. The manager maintains an in-depth knowledge of departmental and product line business processes and directs workflows in a manner that meets overall goals for quality, patient experience, efficiency, cost-effectiveness, and regulatory compliance. Reports to: Director of Clinical Quality

Requirements

Bachelor's in Nursing or Masters in Social Work
[Ohio, United States] Social Worker If Social Worker- LISW-S required.
Minimum of five (5) years of experience in progressive nursing or healthcare experience.
Prior management or leadership experience in the healthcare field.
Certification (or obtain within 3 years of hire) in Care Management, Transitions, Case Management, Quality, or similar specialty area.

Nice To Haves

Prefer prior management or leadership experience in the case management, care management, care transitions, care coordination field.

Responsibilities

Works with director to provide administrative leadership for development, implementation, and evaluation of care management and behavioral case management programs (if applicable) which includes program/population identification, assessment, risk stratification, interventions, and evaluation.
Supervises and directs care management and case management staff (if applicable); registered nurse (RN), social work (SW), and other support staff designated by the director. Works closely with SW Supervisor who serves as primary for SW evaluation, training, and operations (if applicable). Responsibilities include: a. Recruitment, hiring, and remedial intervention and termination of care management staff as appropriate and per policy. b. Conducting perforamance evaluations and feedback; developing and modifying job specific performance dimension, and identifying and scheduling appropriate continuing education. c. Developing, facilitating, and maintaining an effective new employee orientation focused on individual employee needs. d. Devising and implementing performance improvement plans as needed.
Oversight of staff scheduling to support care management goals and regulatory requirements. Performs hands on support as needed to ensure operations support program goals.
Works with leadership and other departments to assess, develop, implement, and evaluate care management strategic initiatives such as medical record documentation, decision-support tools, chronic care initiatives, wellness, length of stay and readmission.
Complies with external regulatory requirements and accreditation standards applicable to care management functions, including: a. Incorporation of standards and regulations into policies and procedures. b. Maintenance of policies and procedures. c. Identifies staff educational needs, develops/designs appropriate staff development programs, and evaluates program outcomes.
Conducts annual performance appraisals, provides ongoing evaluations, and provides feedvack on staff performances and disciplinary actions as needed.
Develops, implements, and maintains processes through which medical management opportunities are recognized and department performance is enhanced, including: a. Utilizing audit tools to evaluate staff performance. b. Developing, implementing, and updating policies and procedures to improve department efficiencies and effectiveness. c. Reviews staff activity for consistency in decision-making and serves as a resource to identify the most efficient and effective patient care options.
Assists the director to determine budget needs for the department.
Maintains open communication lines with director and staff to assure understanding of process changes.
Participates in relevant committees to support strategies to enhance health services.
Responsible for process improvement through evaluation, redesign, documentation, education, and results assessment.
Establishes collaborative working relationships within and outside the organization (includes but not limited to ancillary, nursing, physicians, administration) to support department goals, standards, and strategic initiatives.
Networks with Care Transitions, Ambulatory Care Management, and Network Utilization Management to provide leadership direction and operational support as applicable.
Performs other duties as assigned or required by emergency or other operational reasons for which the employee is qualified to perform.