Care Manager Jobs

About The Position

Requirements

• Bachelor of Science Degree in Nursing or proof of academic achievement towards Bachelors degree in Nursing or related field and must be currently enrolled in a Bachelors program with a targeted date of completion required.
• Four years of acute care hospital environment experience required.
• Care Management experience required.
• Current RN License in Rhode Island
• Certification in Care Management, CCM or ACM required.
• Upon hire will obtain Certification in Care Management within one year of hire if not already in place.
• Basic Life Support (BLS) certification required.
• Ability to establish priorities, meet deadlines, and maintain productivity.
• Ability to form positive collaborative relationships with hospital staff, physicians, patients, families, and post-acute providers.
• Ability to problem solve in a proactive creative manner using sound judgment based on factual information and clinical knowledge.
• Excellent leadership skills and supervisory experience required.
• Ability to lead and actively participate in multidisciplinary teams.
• Knowledge and training in multiple computer systems required to perform position responsibilities (i.e. Cerner, InterQual, 3M, Microsoft Office etc.)
• Ability to work independently and within a team structure.
• Excellent interpersonal skills and communication style.
• Working knowledge of regulatory, Medicare, Medicaid, and third-party payer compliance requirements

Nice To Haves

• Masters’ degree or proof of academic achievement toward a Masters’ degree in Nursing or related field and must be currently enrolled in a Masters’ program with a targeted date of completion preferred.

Responsibilities

• Supports departmental operations to ensure consistency with health system/department policies under supervision of the System Director of Care Management
• Works in collaboration with Director to oversee new employee hiring, orientation, and competency evaluation
• Displays sound managerial judgment in all areas
• Assists System Director of Care Management in planning and monitoring department budget
• Provides service in the most cost-effective manner without compromising the quality of care or customer satisfaction
• Maintains performance, patient and employee satisfaction, and financial standards
• Adheres to CNE facility and department policies and procedures as well as standards from external regulatory agencies and accrediting bodies (i.e. Joint Commission, CMS etc.)
• Assists the hospital and department in meeting and exceeding their commitment to continuous quality improvement
• Assists System Director of Care Management in the planning and implementation of opportunities and new ideas to promote department growth and development
• Supports and leads department strategies and efforts focused on improving key care management metrics
• Assists System Director of Care Management with establishing performance improvement initiatives
• Supports and participates in departmental strategies and efforts focused on improving clinical documentation by physicians
• Designs and develops processes related to Care Management as assigned by Director
• Maintains knowledge of the hospital mission, vision, and values and functions to support them
• Maintains confidentiality at all times related to both patient and employee information
• Develops and updates department orientation/mentoring process for Care Managers and other department staff
• Supports ongoing education and development of Care Managers and other department staff
• Monitors compliance with established policy/procedure and communicates opportunities for improvement to staff
• Assists Director in competency assessments for all staff through audit reviews, shadowing, and performance metrics
• Takes actions to assure improvement on the employee satisfaction survey
• Assists with implementing and evaluating the Department’s daily operations
• Supervises, initiates, and recommends personnel actions for staff
• Approves staffing, assignments, coverage, employee PTO, and payroll approval to ensure appropriate staffing coverage
• Assures appropriate weekend, holiday, and off hours coverage for hospital
• Remains on-call 24/7 for clinical staff as back-up
• Serves as a departmental resource and manages issues/problems escalated by staff
• Holds regularly scheduled Care Management Department staff meetings
• Facilitates training sessions to educate assigned users of applicable case management systems
• Builds and maintains professional relationships with payers and external agencies and keeps staff updated regarding changes.
• Builds and maintains professional relationships with unit managers, Physician Advisor, and CNE leadership to help facilitate aligned goals
• Serves as department lead and clinical expert for Cerner, Careport, InterQual, and other department applications
• Assists with scheduling, coordinating, and training of applications
• Collaborates with System Director in completion of annual performance evaluations for both Care Managers and other department staff
• Attends rounds and maintains a daily working knowledge of cases, helps staff develop solutions to barriers that prevent appropriate discharges
• Maintains knowledge of daily caseloads of staff as it pertains to Discharge Planning and Utilization Review and make decisions to ensure that daily work is completed as required
• Maintains a current knowledge of length of stay data and helps develop strategies for improvement
• Develops data from rounds regarding patient discharge information
• All other duties as assigned.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• Disability insurance
• 401k
• Paid holidays
• Paid volunteer time
• Professional development
• Learning and development program
• Tuition reimbursement
• Employee discount programs
• Wellness programs
• Employee stock purchase plan
• Flexible scheduling
• Home office stipend
• Employee bonus referral program
• On-site amenities
• Pet insurance
• Pet friendly