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

American Addiction Centers • Charlotte, NC

5d • $41 - $62 • Onsite

About The Position

The Post Acute Clinical Program Manager (RN or LCSW) 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. A key aspect of this role involves monitoring, collecting, and analyzing data to evaluate the effectiveness, safety, and quality of patient care within the post-acute care network programs. This includes reviewing readmissions, analyzing root causes, and developing/implementing action plans. The position may also involve participation in quality, readmission, and other relevant committees. The manager addresses questions and concerns from providers, patients, and families regarding post-acute programs in coordination with other care teams, acting as a conduit for problem-solving, resolution, and service recovery. Ensuring accurate patient placement into the Post Acute Network program based on established criteria and providing Utilization Review for specific populations requiring additional oversight are also core responsibilities. The role involves interaction with various hospital administrative teams and leaders, including the Director of Case Management, Home Care Directors, Hospice Directors, Care Managers, Social Workers, Medical Directors, Physicians, APNs, and Nurses. Additionally, the manager facilitates communication with post-acute providers at skilled sites, such as Nursing Home Administrators, Directors, Admissions staff, social services staff, nurses, Physicians, and Advance Practice Nurses. Direct contact with patients and families may occur regarding post-acute program and care options when service recovery or quality issues arise. The manager monitors appropriate post-acute program placement, problem-solves unique situations, and optimizes data collection and information transfer across sites. They also focus on managing and coaching Sub-Acute Skilled Nursing Facility providers to shorten length of stay when appropriate, reduce readmissions, and increase utilization of Advocate Aurora providers. Evaluation of resource utilization, analysis of sentinel events, and follow-up on quality issues are critical. The role addresses issues of non-compliance with staff and MDs regarding patient referrals to appropriate programs, and handles serious quality issues or quality of care trends related to post-acute providers. Recommendations for policies and procedures to enhance service delivery are also part of the role. The position is responsible for relationships within their assigned territory, including assigned hospitals, clinics, and skilled nursing facilities. Other post-acute providers such as physician offices, Home Health Providers, and Assisted Living providers in the territory will also be covered. The role may involve coverage for other positions on a short-term or permanent basis. Travel to meetings with Skilled Nursing Facility Staff is regular. The manager provides support to the clinical team assigned to the facility, removing operational barriers to allow the clinical team to function at the top of their license and focus on medical management. The position requires understanding and adherence 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 with 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 for 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 as well as 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 solving for unique situations, best methods of data collection and transfer of information across sites.
• Finds effective ways to manage and "coach" our 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
• medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• adoption assistance
• paid parental leave
• Defined contribution retirement plans with employer match
• other financial wellness programs
• Educational Assistance Program

What This Job Offers

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