Manager, Clinical Resource & Case Management

Job Description

PURPOSE OF POSITION:

The Manager of the Clinical Resource Department is responsible for the day to day operations and clinical management of the Case Management, Utilization Review and Social Work, with a secondary focus on the Clinical Documentation team. This position will oversee functions of the Clinical Resource Department as they pertain to discharge planning, utilization management, and care coordination/high risk patient process while maintaining the integrity of daily operations. This position is responsible for developing and conducting ongoing education and process improvement for Case Management/Social Work staff.

PRIMARY DUTIES AND RESPONSIBILITIES:

1. Day to day management of the case management and social services program staff and workflows, including scheduling and performance evaluations. Assists the Manager of Operations with the Clinical Documentation team where necessary
2. Rounds on patient units on a regular basis to identify problem areas and assist in the facilitation of the discharge process
3. Ongoing development and completion of continuing education programs for Clinical Resources Management staff, including case managers and social workers specifically related to role functions and implementation of new processes.
4. Provides ongoing program education for new staff, including new Case Managers, the Trainee program hires, social workers, physicians, nurses and allied health professionals as it relates to discharge planning and utilization review.
5. Tracks and trends Clinical Resource Management program compliance. Creates a dashboard to see where opportunities for improvement are and implements process improvement activities around areas identified.
6. Develop, mentor and coach continual improvement in the collaborative practice between physicians, nurses and clinical resource team, and within the clinical resource department itself
7. Analysis and review of program metrics using working knowledge of the systems used in the departments.
8. Stays current with regulatory changes in the case management field.
9. Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.

EDUCATION/EXPERIENCE/TRAINING:

• Bachelor level degree in Nursing required.
• Master’s Degree preferred
• Current Massachusetts Registered Nurse license
• Certification in Case Management or Clinical Documentation Integrity preferred
• Two years’ experience in process improvement
• Minimum 5 years Case Management experience in an acute setting.
• Experience in development and presentation of professional continuing education programs
• Knowledge of CMS regulations
• Excellent computer skills – familiarity with Windows based software programs
• Organizational, analytical, writing and interpersonal skills
• Management/supervisory experience preferred

Schedule Details:

Full-Time, Monday-Friday, Occasional Evenings, On-Call for Weekends, & Holidays

Pay Range Details:

The pay range displayed on each job posting reflects the anticipated range for new hires. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set, and education. This is not inclusive of the value of Cape Cod Healthcare’s benefits package (if applicable), which includes among other benefits, healthcare/dental/vision and retirement. For annual salaries this is based on full-time employment.