Case Management Manager

40 Hours per week

Day Shift

Job Summary: The purpose of this position is to promote the advancement of coordinated, cost-effective, quality patient care and services within the acute care hospital in partnership with the Director of Case Management and Deaconess health system care coordination strategy. Under the direction of the Director of Case Management and in collaboration with other department managers within Deaconess, provides oversight and direction of the care coordination department functions to integrate unit-based case management and social work functions with the unit care delivery system. Collaborates with nurse leaders at all levels to promote evidence-based practice and standards of care across nursing units. In addition, collaborates with other department managers and directors, health care providers, and information services leaders to meet Deaconess Hospital, Inc. annual goals and strategic priorities. Employee must be able to successfully complete job specific orientation, competencies, and meet/exceed standards.

Education Qualifications

• Bachelor’s Degree in nursing Required or
• Master’s degree in social work Required

Experience Qualifications

• Minimum of five years' relevant experience of hospital experience recommended. Required
• Minimum of three years' relevant experience of case management supervisory experience Preferred

Skills and Abilities

• Maintained competency and continuing education in area of discipline-specific professional practice required.
• Demonstrated project management skills using six sigma methodology preferred.
• Knowledge of EPIC electronic health record preferred.
• Ability to read, analyze, and interpret the most complex documents.
• Ability to respond effectively to the most sensitive situations.
• In addition to meeting the basic standards of an Acute Case Manager, the Team Leader is expected to role model and exceed the Standards of Performance.
• She/he is to assume accountability for the quality of case management services delivered to our patient population.
• The Team Leader provides case management services and oversees the services provided by other case managers and social workers in the department.
• The Team Leader coordinates orientation of the staff members, participates in evaluating their performance, and provides continuing education.
• In conjunction with the Manager, the Team Leader is also responsible for planning and managing the resources necessary for the patients we serve as well as the department.
• The Case Manager must be able to demonstrate knowledge of growth and development to coordinate patient care appropriate to the age of patients served on his/her assigned clinical area.
• Employee must be able to successfully complete job specific orientation, Case Management specific competencies, and meet/exceed standards as identified in the criteria based performance appraisal.
• Ability to work with mathematical concepts such as probability and statistical inference.
• Ability to apply concepts such as fractions, percentages, ratios and proportions to practical situations.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form and deal with several abstract and concrete variables.
• This job requires computer and systems competency in the following area(s): *Enters *Retrieves *Assembles and organizes, uses and analyzes data.
• Integrates diverse sources of data.
• Ability to learn and use the provided electronic medical record system within three months of attaining position.
• Ability to apply and document Severity of Illness and Intensity of Service in hospital provided software.
• Ability to utilize denial prevention technology i.e. recorded, monitored and automated calls, and documents tracking numbers.
• Verifies faxes are received and retrieves and processes voicemail in timely manner.
• Demonstrates high degree of skill in interpersonal relations with the ability to deal effectively on a one-on-one and group basis with physicians, nursing staff, administration and other department staff.
• Facilitates effective communication between care team members, patients, and family members regarding treatment goals and daily care.
• Follows through to assure patient issues are appropriately resolved in a timely manner.
• Demonstrates skills as a resource and consultant to patients, families, and physicians.
• Demonstrates efforts to establish and maintain positive professional relationships with staff in the Case Management Department.
• Demonstrates ability to participate appropriately in conflict resolution.
• Demonstrates flexibility in work assignments.
• Participates on department/care center/or hospital committees as appropriate.
• Follows safety and infection control policies of the hospital.
• Basic understanding of Medicare/Medicaid, insurance and regulatory guidelines, level of care (Rehab, Skilled) preferred.
• Knowledge of medical and allied health sciences to apply criteria to the medical record with respect to patient needs for medical and health care.
• Knowledge of evidence based practice, medical terminology, levels of care, treatment modalities and the present health care delivery system, both hospital and community based.
• Knowledge of financial management.
• Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.
• Focuses on the right issues at the right time.
• Acts on important and urgent tasks before tackling less important ones.
• Manages difficult or emotional customer situations.
• Responds to requests for service and assistance; meets commitments.
• Speaks clearly and persuasively in positive or negative situations.
• Listens and gets clarification.
• Responds well to questions.
• Demonstrates group presentation skills.
• Participates in meetings.
• Balances team and individual responsibilities.
• Contributes to building a positive team spirit.
• Delegates work assignments appropriately.
• Looks for ways to improve and promote quality.
• Exhibits sound and accurate judgment.
• Includes appropriate people in decision-making process.
• Makes timely decisions.
• Meets standards and reports productivity timely and accurately.
• Completes work in a timely manner.
• Strives to increase productivity.
• Prioritizes and plans work activities.
• Adapts to changes in the work environment; manages competing demands; able to deal with frequent change, delays, or unexpected events.
• Is consistently at work and on time.
• Ensures work responsibilities are covered when absent.
• Arrives at meeting and appointments on time.

Licenses and Certifications

• Current RN Required or
• Social work licensure in applicable state. Required
• Certification in Case Management Required or
• plan in place to obtain within 2 years of hire date