- The Patient Care Management Manager, in collaboration with organizational leadership, is responsible for formulating, implementing, and evaluating clinical and operational initiatives using evidence-based practices to create a comprehensive care management program that aims to improve care, increase patient satisfaction, and decrease costs. The Manager is responsible for daily operations, including, but not limited to, staffing/scheduling, evaluations, mentoring, and counseling. The Manager will provide supervisory oversight to the clinical and non-clinical care management staff, to include training and competency development of team members, establishing standard work for all roles, and performing ongoing audits and assessments. He/she will also be responsible for utilization management supporting medical necessity and denial prevention, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction, care coordination by demonstrating throughput efficiency while assuring care is timely and at the appropriate level of care, and ensuring compliance with state and federal regulatory requirements, as well as The Joint Commission and other accreditation standards.
- RN with BSN required.
- Master's Degree preferred in nursing, healthcare administration, or business administration.
Required License and/or Certification
- Case manager certification required upon hire, or obtained within three years of hire.
- At least five years' experience in clinical nursing role.
- At least three years' experience in case management, care coordination, disease management, ambulatory care, or combination preferred.
- At least two years of managerial/supervisory experience in the medical field.
- Must be able to organize effectively, work under restraints of time, pressure, accuracy, and interruptions.
- Prioritizes accomplishment of goals and objectives to meet the changing needs of the Patient Care Management department.
- Must possess good communication and interpretive skills, both written and oral.
- Ability to foster teamwork and mentor staff at all levels.
- Must exhibit skills of communication, compassion, persuasion, and helpfulness when dealing with patients and families.
- Adjusts to changes in policies, procedures, schedules, and fluctuations in workload.
- Maintains and exhibits positive mental attitude.
- Working knowledge of computer, electronic health record, and Microsoft Office Suite.
- Readily assumes additional responsibilities.