Catholic Health Initiatives Care Management Manager - Care Coordination/Utilization in DES MOINES, Iowa

Care Management Manager - Care Coordination/Utilization

Description

GENERALSUMMARY :

Provides leadership for the Care Management

Department in understanding, supporting, and reflecting the Mercy Mission. In conjunction with the Director; plans,

coordinates, facilitates and evaluates Case Management/Social Work Services

that contribute to the successful achievement of Mercy Medical Center. Integrates and coordinates care of

individuals across the healthcare continuum.

Facilitates the interdisciplinary plan of care in order to meet multiple

service needs, promotes continuity through elimination of fragmentation of

care/service, and facilitates the effective utilization of resources. Serves as educator and a central source of

communication for the individual and their support systems. Supports functions

and goals of the ACO and CIN.

ESSENTIALFUNCTIONS :

  • Demonstrates and encourages communications and interpersonalrelationships in dealing with physicians, hospital staff, patients, familiesand the general public, promoting a positive perception of patient care.

  • Facilitates cohesiveness with the Care Management Department.

  • Assists in managing resources to meet quality and financial goals.

  • Investigates barriers and problem areas to resolution, leading to asuccessful outcome.

  • Evaluates and adjusts caseloads according to organizational needs.

  • Keeps the Care Management RNs and social workers apprised ofinstitutional information and department communication.

  • Assumes responsibility for maintaining current professional andclinical expertise. Promotes personaland professional growth among co-workers.

  • Assists the Director with duties such as personnel evaluations,timekeeping, employee counseling, disciplinary action, hiring, orientation, andwith 24 hour accountability for area of responsibility.

  • Assists the Director with department accreditation requirements.

  • Completes a comprehensive assessment of the individual’s health statusincluding clinical conditions, support systems and resources to identify needsand make referrals to appropriate multi-disciplinary services.

  • Monitors and coordinates an interdisciplinary plan of care that is inpartnership with the individual and their support services for needs andservices across the health care continuum and for transition through the levelsand locations of care.

  • Documents the case management plan to include: clinical needs, barriers to quality care andeffective utilization of resources and referrals in a timely, legible manner.

  • Demonstrates a working knowledge of financial and reimbursementprocesses to facilitate medical cost management, including best practices,effective utilization of resources, linking clinical and financial aspects ofcare, and access to care and level of care.

  • Addresses length of stay issues and level of care changes forcompliance.

  • Provides education for the individual and family and for the teamregarding benefits, utilization of resources, levels of care, and expectationsof the transition process throughout settings across the healthcare continuum.

  • Modifies individual approach to case management services in response topatient/family progress and/or feedback.

  • Utilizes holistic approach (considering psychosocial, spiritual,educational, safety and related criteria) appropriate to the age of clientsserved.

  • Collaborates with physicians, directors, managers and staff in thecollection and reporting of data to evaluate outcomes and improve quality andefficiency.

  • Performs functions other than described above to meet the needs ofpatients/families and the department. Dutiesand responsibilities may be added, deleted or changed at any time at thediscretion of the Director, formally or informally, either verbally or inwriting.

Qualifications

MINIMUMKNOWLEDGE, SKILLS AND ABILITIES REQUIRED :

  • Three years of R.N./Social Work clinical experiencein focused areas working with multidisciplinary teams.

  • Licensed by the State of Iowa as an R.N./L.I.S.W.

  • Specialty certification preferred.

  • Proof of completion of Mandatory Reporterabuse training specific to population servedwithin three (3) months of hire.

Job Director/Manager/Supervisor

Primary Location IOWA-DES MOINES-MERCY MEDICAL CENTER

Daily Schedule Days

Scheduled Hours per 2-week Pay Period 80

Weekends Required None

Req ID: 2018-R0178297

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.