Manager Care Management

Requisition ID
2021-166855
Employment Type
Full Time
Department
Care Management
Hours / Pay Period
80
Shift
Day
Standard Hours
8am-5pm
Facility / Process Level : Name
CHI Saint Joseph Health System
Location
KY-LEXINGTON

Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

Full time, day shift, Saint Joseph Main Hospital, Care Management 

Qualifications

Job Summary:

Provides leadership to Care Management RNs, Social Workers, and support staff to accomplish the operational functions and performance goals of the department, which include efficient patient throughput, safe and effective care transitions, and compliance with payer and regulatory requirements.

 

Essential Functions:

  • Operational Efficiency
    1. Schedules team members so department is adequately staffed and patient needs are met.
    2. Monitors and adjust staffing to achieve productivity targets and accomplish essential work functions of department.
    3. Adjusts staff workloads to meet demand and ensure work is accomplished in a timely manner.
    4. Monitors expenses against budget and plans proactively for departmental costs and charges. Works with director to develop department budgets.
    5. Effectively uses managerial tools and software (e.g. Kronos, Workday, Premier, Lawson, Webnow).

 

  • Staff Performance
    1. Interviews and hires staff that are competent and will assist with meeting department goals.
    2. Trains and develops staff to ensure their work is of high quality and aligned with departmental, regulatory and payer requirements.
    3. Evaluates staff performance fairly and provides meaningful feedback on progress towards performance goals..
    4. Observes and coaches staff as they perform their work to give real-time feedback.
    5. Engages staff in department, hospital, and CHI St. Joseph Health goals and results. Works with staff members to develop and achieve their own performance goals.

 

  • Resource/Role Model
    1. Provides expertise in problem-solving for difficult patient issues.
    2. Knowledgeable in all aspects of Utilization Management and Care Management, including CMS regulatory requirements, and ensures compliance.
    3. Demonstrates excellent communication and negotiation skills.

 

  • Achieves Results
    1. Uses data to monitor and communicate department performance metrics.
    2. Identifies areas for improvement and participates/leads performance improvement activities.
    3. Possesses strong organizational skills. Able to prioritize and delegate to manage a challenging workload. Holds staff accountable to accomplish assigned work.
    4. Aligns with organizational goals and works collaboratively with direct reports, peers and hospital leadership to achieve results.
    5. Partners with payers and Revenue Cycle to improve financial performance and ensure payer processes and requirements are met.
    6. Works collaboratively with patients, families, physicians and community partners for care transitions.

Job Requirements

 

Education / Accreditation / Licensure (required & preferred):

 

  • Current unrestricted license as a registered nurse or social worker in state(s) of practice is
  • Registered Nurse: Bachelor of Science in Nursing required; Masters of Science in Nursing
  • Social Worker: MSW required.

Experience (required and preferred):

 

  • Minimum 5 years clinical experience as Registered Nurse (RN) or Social Worker
  • Minimum 2 years managed care or equivalent care management experience required.
  • Minimum 1 year leadership experience preferred.

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