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MANAGER-CASE MANAGEMENT

Company: The Methodist Hospitals
Location: Gary
Posted on: November 17, 2020

Job Description:

Provides leadership and management for the Department of Case Management, Social Services and Clinical Resource Management. Responsible for operational and human resource issues and issues related to LOS and CMI, Discharge Planning, Case Management, and Utilization Review. Oversees a systematic, holistic, outcome oriented, customer-focused and cost-effective approach to the integration and coordination of services for patients throughout all levels of the organization.

PRINCIPAL DUTIES AND RESPONSIBILITIES(*Essential Functions)

Assume effective and efficient resource utilization for patient in continum of care.

Assures timely and accurate utilization services for the organization to include, appropriateness of admission, CMI and LOS.

Responsible for the development of systems and programs to integrate appropriate levels of care.

Oversees the co-ordination of discharge planning and post hospital planning which incorporates professional social work standards.

Promotes the growth and development of all employees through coaching, counseling, and self-education.

Provides effective orientation training and development of staff.

Provides leadership, management and direction for the Case Management, Social Services and Utilization Review staff to assure timely intervention in the patient's treatment plans, appropriate communications with health care team and utilization management and ongoing assessment of the clinical progress for timely discharge and transfers to other levels of care within the organization.

Provides oversight to Utilization team leaders related to appeals, denials, correspondence with payors and regulatory bodies.

Reviews and analyzes patient outcome data to determine program and service line changes as it relates to cost effectiveness, quality integration of care and patient, payor and physician satisfaction.

JOB SPECIFICATIONS(Minimum Requirements)

KNOWLEDGE, SKILLS, AND ABILITIES

Demonstrated knowledge and skills to provide care appropriate to the infant, child, adolescent, young adult, middle adult and geriatric patient service on his/her service unit.

Demonstrated knowledge of the principles of growth and development over the life span.

Demonstrates principles of excellent customer service and responds positively to the needs of patients and family.

Excellent interpersonal skills using tact and diplomacy in interventions with staff, patients and public.

Excellent communication skills both verbally and in writing.

Must be able to work cooperatively in a multi-disciplinary team.

Ability to assess and interpret data about the patient's status in order to identify each patient's age specific needs and provide the care needed by the infant, child, adolescent, young adult, and geriatric patient groups serviced.

Ability to supervisor and give work directs to others.

Ability to professionally handle stressful situations

EDUCATION

Bachelors Nursing Required

4 Healthcare/Medical - Case Management Preferred

4 Healthcare/Medical - Nurse: Staff Required

Licensed Registered Nurse

Certified Cardiac Pulmonary Resuscitation

STANDARDS OF BEHAVIOR

Meets the Standards of Behavior as outlined in Personnel Policy and Procedure #1, Employee Relations Code.

CONFIDENTIALITY/HIPAA/CORPORATE COMPLIANCE

Demonstrates knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family, organizational and other medical information. Understands and supports the commitment of Methodist Hospitals in adhering to federal, state and local laws, rules and regulations governing ethical business practices for healthcare providers.

DISCLAIMER - The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.

Keywords: The Methodist Hospitals, Gary , MANAGER-CASE MANAGEMENT, Other , Gary, Indiana

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