Supervisor- RN Case Manager

University of Mississippi Medical Center•Jackson, MS

5d•Onsite

About The Position

This role will drive positive outcomes for designated patient groups by providing oversight; education; clinical direction/redirection; accountability; escalation & resolution of issues for RN Case Manager I positions, and assisting social workers within the clinical aspect of discharge planning. This position supervises RN Case Managers (primary) & other staff within the care coordination department; actively participates in the hiring of new team members; develops process flows; provides input for staff educational material; collaborates with all members of the provider care team to identify opportunities for improvement; reaches out to external customers to escalate issues and remove discharge barriers. This positions functions under the guidelines of patient centric nursing process utilizing UMC nursing model, actively participating in the “Magnet” journey related to nursing practice and behavior works to directly manage length of stay (LOS-targets for assigned populations) and assure efficient utilization of resources through the prevention of avoidable days (data capture, analysis, reporting and recommendation for change) and unplanned readmissions. Acts. Individuals within RN Case Manager II position are strategic, innovative and utilize critical-thinking to create optimal patient/staff/customer outcomes while supporting organizational mission, vision and values.

Requirements

Two (2) years of bedside RN experience and two (2) years of utilization management or case management/coordinated care experience in an acute care environment.
Valid RN license.
Accredited Case Manager Certification (ACMC) or Certified Case Manager (CCM) required post-hire within 24 months.
Must demonstrate excellent interpersonal communication and negotiation skills with leadership capability.
Understanding of discharge planning, utilization management, case management, performance improvement, managed care reimbursement, data collection, analysis and report development or interpretation.
Understanding of pre-acute, acute and post-acute venues of care and post-hospitalization community resources.
Drives achievement of patient “right care, right time, right place” practice.
Ability to work independently and exercise sound clinical judgement with all decision-making.
Ability to demonstrate high levels of emotional intelligence in fast-paced, high-stress environment.
Ability to understand and perform all duties/responsibilities within the RN-Case Manager I role successfully.
Develops and delivers successful educational sessions to co-workers.
Manages successful implementation of case management and nursing models.
Is viewed by peers as a departmental leader.

Nice To Haves

Academic medical center experience preferred.

Responsibilities

Oversees the management of assigned patient populations across the continuum.
Serves as a resource to the multidisciplinary/multi professional team to manage appropriate and safe patient care transitions.
Works with departmental/physician/nursing leadership and the healthcare team for defined patient populations assisting to implement clinical pathways as appropriate.
Drives patient satisfaction related to discharge planning and assures all patients are assessed for timely, appropriate and safe discharge planning.
Serves as the primary information resource for case management staff, payors, and physicians, other healthcare team members, customers and regulatory bodies. (skill areas include regulatory requirements, pathway implementation/ i, ethics/ healthcare law, clinical skills, etc.).
Conducts training sessions and workshops to educate case managers on best practices, policies, procedures, and relevant regulations.
Provides ongoing education and professional development opportunities to enhance team members' skills.
Identifies potential risks or barriers to effective case management, implements strategies to mitigate risks, and addresses any issues or concerns that may arise during the course of patient care/discharge planning.
Educates others on case management responsibilities.
Readily accepts responsibility for actions/discharge planning/appropriate utilization provided by assigned team.
Assumes delegated activities from the manager/director/chief officer as requested.
Addresses/resolves system problems impeding diagnostic or treatment progress.
Proactively mitigates risk to patients with special focus on clinical discharge planning using the nursing process of assessment, intervention, implementation, and evaluation.
Seeks consultation from appropriate disciplines/ departments/leaders as required to expedite care and facilitate safe discharge.
Utilizes critical-thinking and demonstrates innovative thought.
Ensures compliance with regulatory requirements, accreditation standards, and organizational policies.
Reviews documentation to ensure accuracy, completeness, and compliance with legal and ethical standards.
Identifies at-risk populations and establishes or identifies intervention to reduce risk and implements reporting procedures.
Takes actions to achieve continuous improvement and understands continuous improvement methodology.
Ensures that all elements critical to the discharge plan have been communicated to the patient/family and members of healthcare team.
Assures appropriate documentation is completed on all patient groups timely, accurately and concisely.
Responsible for coordinating seamless discharges.
Drives initiatives to reduce excess days.
Works to improve staff satisfaction through team building.
Recognizes the importance of a dyad model utilizing social worker(s) as needed related to social work expertise.
Is customer driven and focused, recognizing customers include but are not all inclusive of co-workers, providers, payers, nurses, and ancillary staff in addition to outside entities accepting patient referrals or working to provide supplies/equipment.
Obtains necessary CEUs to maintain an active RN license.
The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.