PRINCIPAL DUTIES AND RESPONSIBILITIES
Provides leadership through the coordination and management of projects that support Care Management staff development and education initiatives in accordance with Care Management and CCHS philosophies and goals.
Collaborates with Care Management leadership, other system leaders, staff, and subject matter experts to achieve goals.
Participates in the assessment of staff learning needs to identify developmental/educational priorities, designs, develops, and delivers education utilizing adult learning principles that are in accordance with Care Management and CCHS strategic vision and goals.
Researches, recommends, and collaboratively develops course materials, learning strategies, and common methods to support Care Management staff development and education initiatives including instructional tools, audiovisual materials, and dynamic exercises for initiatives.
Establishes appropriate evaluation methods to measure performance to outcomes. Participates in measuring effectiveness of course facilitation, content, and materials through pilot programs and course evaluations. Revises content for improvement.
Engages staff in developmental and educational activities.
Plan, organizes, and coordinates Care Management Services orientation and ongoing education/training for all staff.
Collaborates with the members/family, physicians, staff, and other health care professionals across the continuum to provide care coordination.
Reports information generated from available sources to support operational, clinical, financial, and outcome goals.
Collaborates with the physician advisor to facilitate achievement of clinical, quality, financial, and member satisfaction goals.
Measures effectiveness of interventions through direct communication with members and caregivers and data collection of defined indicators (e.g. overall length of stay, readmission rates, feedback from referral sources, etc.)
Serves as a resource to Care Management staff, providing education on care management.
Builds trusting relationships with internal and external customers, i.e., physicians, nurses, members and their families, vendors, payers, etc.
Assumes responsibility for professional growth, shares knowledge with co-workers and health care team members.
Monitors compliance with all regulatory standards.
Participates in case management review, disease management program, and research meetings as needed.
Assists with data collection and implementation of action plans for CMS, JCAHO, AHA Quality Initiative, as well as CCHS defined measures.
Communicates with Care Management Leadership, data collection results and directs change needed to come into compliance.
Identifies opportunities for improvement, recommends strategies, and supports PI initiatives to improve program outcomes.
Performs assigned work safely, adhering to established system safety rules and practices; reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, members or visitors.
Performs other related duties as required
EDUCATION AND EXPERIENCE REQUIREMENTS:
- Registered Nurse with BSN required, MSN preferred.
- Minimum of 10-years of nursing experience, preferred in Management/Case Management or disease/population management, Utilization Management, Case Management, Health Coaching, Health Plans, and or Home Care.
- Maintains continuing education related to role enhancement and changes of clinical practice within assigned area.
- Attends additional educational offerings related to disease/population management, public health, and care transitions.
- Certified in case management or obtain within 18months.
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