Post Acute Clinical Program Manager (RN or LCSW) SNF Network FT

Advocate Health and Hospitals Corporation • Charlotte, NC

25d • Remote

About The Position

The Post Acute Clinical Program Manager serves as a crucial liaison between the hospital and the post-acute network (PAN) skilled nursing facilities. This role is responsible for managing and facilitating communication between inpatient care managers, external care providers, and outpatient care managers for patients transitioning in and out of the acute care setting and post-acute programs. The manager assists in the transition of patients to post-acute programs and their eventual return to their primary care physician (PCP) and community. Key responsibilities include monitoring, collecting, and analyzing data to evaluate the effectiveness, safety, and quality of patient care within the post-acute care network programs, as well as reviewing readmissions, analyzing root causes, and developing/implementing action plans. The role also involves addressing questions and concerns from providers, patients, and families regarding post-acute programs, acting as a problem-solving conduit, and ensuring accurate patient placement into the Post Acute Network program based on established criteria. Additionally, the manager provides Utilization Review for specific populations requiring additional oversight and interacts with various hospital administrative teams, directors, care managers, social workers, physicians, and nurses. Communication with post-acute providers at skilled sites, including Nursing Home Administrators, Directors, Admissions staff, social services staff, nurses, Physicians, and Advance Practice Nurses, is essential. While direct patient contact is limited, it may occur regarding post-acute program and care options when service recovery or quality issues arise. The manager monitors appropriate post-acute program selection, problem-solves unique situations, and oversees data collection and information transfer across sites. A significant aspect of the role involves managing and coaching Sub-Acute Skilled Nursing Facility providers to optimize length of stay, reduce readmissions, and increase utilization of Advocate Aurora providers. This includes evaluating resource utilization, analyzing sentinel events, and following up on quality issues. The manager addresses non-compliance with staff and MDs regarding patient referrals and serious quality issues or quality of care trends related to post-acute providers, and makes recommendations for policies and procedures to enhance service delivery. The position is responsible for relationships within their assigned territory, including hospitals, clinics, and skilled nursing facilities, as well as other post-acute providers like physician offices, Home Health Providers, and Assisted Living providers. Coverage for other positions may be required on a short-term or permanent basis. Travel to meetings with Skilled Nursing Facility Staff is regular. The role provides support to the clinical team assigned to the facility, removing operational barriers to allow the clinical team to function at their highest capacity and focus on medical management. The manager is responsible for understanding and adhering to the organization's Code of Ethical Conduct and ensuring compliance with applicable policies, regulations, and laws.

Requirements

• Bachelor’s degree or equivalent in Nursing or related field and/or Masters in Social Work
• Registered Nurse license issued by the state in which the team member practices, OR Licensed Clinical Social Worker (LCSW) or LCSW-A working towards full licensure
• Certification in Certified Case Management (CCM)
• Typically requires 5 years of experience in healthcare industry
• 1 year of case management and quality improvement experience
• Must be able to lift and support the weight of 35 pounds in handling patients, medical equipment and supplies.
• Must speak and understand English fluently and have an intact sense of sight, hearing, smells, and finger dexterity.
• Critical thinking and ability to concentrate.
• Must be able to be mobile with the entire healthcare system and other facilities.
• Must be able to respond quickly to changes in patients and/or program conditions.

Nice To Haves

• Experience in post-acute setting
• Care management experience
• Utilization management experience

Responsibilities

• Serves as the liaison between the hospital and the post-acute network (PAN) skilled nursing facilities.
• Manages and facilitates communication between inpatient care managers, external care providers, and outpatient care managers for patients transitioning in and out of the acute care setting and post-acute programs.
• Assists the transition of patients to post-acute programs and eventually back to their primary care physician (PCP) and community.
• Monitors, collects, and analyzes data to evaluate the effectiveness, safety, and quality of patient care in the post-acute care network programs.
• Reviews readmissions, analyzes root causes, develops and implements action plans.
• Participates in quality, readmission, and other committees as needed.
• Addresses questions and concerns by providers, patients, and families regarding post-acute programs in coordination with other care teams.
• Acts as a conduit for problem solving, resolution, and service recovery.
• Ensures accurate placement of patients into the Post Acute Network program based on established criteria.
• Provides Utilization Review for specific populations that need additional oversight.
• Interacts with hospital administrative teams and leaders, Director of Case Management, Home Care Directors, Hospice Directors, Care Managers, Social Workers, Medical Directors, Physicians, APN's and Nurses.
• Facilitates communication with post-acute providers at the skilled sites such as Nursing Home Administrators, Directors, Admissions staff, social services staff, nurses, Physicians SNF and Advance Practice Nurses.
• Will have some contact with patients and families regarding post-acute program and care options when service recovery and/or quality issues arise.
• Monitors which post-acute program is appropriate for patients, problem solves for unique situations, best methods of data collection and transfer of information across sites.
• Finds effective ways to manage and "coach" Sub-Acute Skilled Nursing Facility providers to shorten length of stay when appropriate, reduce re-admissions and increase utilization of Advocate Aurora providers.
• Evaluates utilization of resources, analysis of sentinel events and follow up on quality issues.
• Addresses issues of non-compliance with staff and MDs regarding referring patients to appropriate programs.
• Addresses serious quality issues or quality of care trends related to post-acute providers.
• Makes recommendations for policies and procedures that can enhance the service delivery.
• Responsible for the relationships within their assigned territory and responsible for their assigned hospital, clinics and skilled nursing facilities within their territory.
• Covers other Post Acute providers such as physician offices, Home Health Providers and Assisted Living providers in the territory of the assigned hospital.
• Provides coverage for other positions as needed on a short-term or permanent basis.
• Travels to meetings regularly with Skilled Nursing Facility Staff.
• Provides support to the clinical team assigned to the facility, removing operational barriers that will allow the clinical team to function at the top of their license and focus on the medical management of their panel.
• Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business.

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

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