Job DescriptionJob Summary:
Oversees and manages care management department operations to ensure optimal efficiency and effectiveness. Reviews performance data and reporting to monitor and measure productivity. Monitors performance and provides mentorship and leadership to team. Recognizes trends in barriers to coordinated care and strategizes and executes remediation plans. Monitors and disseminates regulatory changes impacting the revenue cycle.
Job Requirements:
Education and Work Experience:
- Bachelor's Degree or equivalent combination of education/related experience: Required
- Master's Degree: Preferred
- Five years' case management, hospital discharge planning and utilization review or social work experience: Preferred
- One year's leadership experience: Preferred
Licenses/Certifications:
- Registered Nurse (RN) licensure in the state of practice: Preferred
- Licensed Master Social Worker (LMSW) - State Board: Preferred
- Licensed Clinical Social Worker: Preferred
Essential Functions:
- Reviews performance data and reporting to monitor and measure productivity and department effectiveness. Implements length of stay, readmissions, and other key strategies.
- Monitors team performance in meeting patients' needs of socio-economic intervention in collaboration with the care management team.
- Monitors the delivery of coordinated care and the implementation of comprehensive individual plans. Models content expertise to patients, families, and peers.
- Provides mentorship and leadership to all peers and members of the care coordination team.
- Recognizes trends in barriers to coordinated care and strategizes and executes remediation plans. Monitors and disseminates regulatory changes impacting the revenue cycle.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
