RN Supervisor, Care Management, Frazier Rehab Institute

UofL Health•Louisville, KY

3d•Onsite

About The Position

The Care Management Supervisor is responsible for oversight and management of the rehab case management departments. The Supervisor promotes optimal patient outcomes in accordance with the policies, procedures, applicable laws and contracts, philosophy, mission, vision and values of UofL Health. The case management department drives of length of stay and readmission outcomes for the facility. The case management supervisor works to ensure institutional compliance with regulatory agencies and third-party payers. The supervisor must demonstrate a working knowledge of finance, reimbursement, third party payers, community resources/agencies, accreditation standards, quality improvement, clinical care, and organizational issues. Utilizes the management process (plan, organize, direct and control) to provide a framework for decision-making. Maintains confidentiality of information; actively supports organizational goals and objectives by providing needed information to divisions and departments. Must be able to adjust priorities quickly, organize multiple tasks simultaneously, and work interdependently with many levels of staff. Attention to detail; strong organizational, interpersonal and communication skills; and innovative problem-solving skills required. Must be able to adjust work hours depending upon departmental and organizational needs as determined by the director.

Requirements

Must have RN with a BSN.
Two (2) years as Care Manager/Utilization Review Nurse
Unrestricted RN license in the state of Kentucky (required).
BLS-CPR (required)
Basic computer skills, including the use of electronic medical records (required)
Knowledge of Microsoft Word, Excel, Outlook, Electronic Medical Record, Internet (required)

Nice To Haves

Master’s Degree in Nursing, Business, Health Care Administration or equivalent preferred.
Two (2) years rehab hospital experience (preferred)
Case Management Certification (ACM, ANCC-Nurse Case Manager or CCM) (preferred)

Responsibilities

Promotes the care management team’s use of clinical resources by conducting timely initial admission assessments based on clinical indicators and anticipated service needs; readmission risk assessments, timely referrals to ancillary & post-acute services, recommendations for appropriate level of hospital care, and validation of patient demographics and payor source.
Assists with the development of policies and procedures to ensure departmental compliance with regulatory, ethical, legal, and accreditation standards, guidelines and regulations.
Develop monitoring and tracking systems to improve data collection for the sole purpose of improving length of stay, readmissions, and use of hospital ancillary services in order to enhance reimbursement.
Ensures the development and documentation of the multidisciplinary clinical assessment of patients on an on-going basis.
Assists with the development of policies and procedures to ensures departmental compliance with regulatory, ethical, legal, and accreditation standards, guidelines and regulations.
Evaluates technology, resources, and tools for application and use in daily operation and make recommendations which will improve our processes, systems, and revenue.
Promotes education and involvement of staff; encourages certification.
Demonstrates ability to motivate staff in a positive manner and to improve cohesiveness of the group.
Participates in professional organizations; keeps abreast of changes in the field and pro-actively seeks to keep the hospital up to date.
Represents the department in leadership activities as needed (committee work, JCAHO preparation, meetings, etc.); serves as a professional role model for others.
Collaborates with clinical and financial staff to meet financial goals of the hospital.
Aware of reimbursement changes, problems and patterns of reimbursement, taking action as needed to improve or resolve issues.
Works with the director and staff to develop departmental goals to support the mission and direction of the hospital.
Enhances professional growth and development through participation in educational programs, reading current literature, attending in-service meetings and workshops that are related to assigned areas of responsibility. Assumes responsibility of growth and development, maintains competency in care management principles.
Committed to patient satisfaction and uses appropriate tools and services recovery to meet expected patient satisfactions metrics
Actively involved to meet organization metrics and goals to ensure the financial security of the organization.
Advocates for patient/family needs in a respectful, unbiased, and confidential manner.
Educates physicians, patients and staff with regards to payors, financial issues, documentation, and potential compliance issues.
Serves as a resource to physicians for clinical management and financial issues. Assists the providers with promoting efficiencies in the care delivery system and reducing/ eliminating barriers to efficient/effective service.
Possess strong problem-solving skills and takes initiative to so. Works effectively with others. Knowledgeable of the services lines and uses sound nursing judgement and adheres to the code of professional conduct.
Promotes departmental goals of improved quality, improved patient outcome and conserving resources as evidenced by value enhancement activities.
Ensures compliance with rehab CARF accreditation standards.
Maintains a case management caseload that fluctuates with volumes and needs of the department.
Knowledgeable of state laws, CMS conditions of participation, CARF standards, and TJC standards regarding regulatory requirements for care management and discharge planning and compliance with each.
Maintain compliance with all company policies, procedures, and standards of conduct.
Comply with HIPAA privacy and security requirements to always maintain confidentiality.
Attend specialty service line case conferences and staff meetings.
Maintains an active, unrestricted Kentucky Registered Nurse Licensure.
Maintains current Basic Life Support-CPR.