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Case Management Supervisor in Marinette, WI at Bay Area Medical Center

Date Posted: 10/23/2018

Job Snapshot

Job Description

Location:  Bay Area Medical Center
Requisition Number:  2365
# of Openings:  1
Title:  Case Management Supervisor
Department:  7780 - Case Management
Position Type:  Exempt – Full time
Shift:  1 – Days
Hours:  primarily days
FTE:  1.0
40 hr. waiver required:  No
Is call required:  No
Weekend Rotation:  None
Removed Internally:  10/27/18

TITLE:                       Case Management Supervisor

Department:             Case Management
Reports to:               Chief Nursing Officer
Supervises:             Case Managers, Social Workers

 
Job Summary:

The Case Management Supervisor collaborates with the CNO to plan, organize and direct the activities of the Case Management staff in accordance with the mission, vision and strategic goals of the organization, federal and state laws and regulations and accreditation standards. The Case Management Supervisor is responsible for administering the hospital’s Utilization Management Plan and uses effective performance improvement skills to engage the Case Management staff, hospital clinical leaders, staff and physicians in achieving targeted utilization management outcomes. Coaches and leads efforts toward achievement of evidence based practice, standardization of care, and effective disease management strategies which result in best practice utilization outcomes.

Essential Functions:

  1. Collaborates with the CNO on development of annual departmental goals, Management Objectives and Outcome targets aligned with the organizational mission, vision, PI Councils’ (Growth, Quality, Cost, Service & People) and the strategic plan, with a high focus on inpatient efficiencies. Is data-driven and analytical in planning.

  2. Collaborates with the CNO on development of a yearly budget and operates within the budget. Pays a constant focus to resource management opportunities.

  3. Supervises and mentors Case Management Department staff to assure role expectations are met and the organization is delivering best practice case management services.

  4. Effectively engages the Physician Advisor, the Hospitalists and the HIM/CM/IT Committee in utilization management PI efforts relative to providers’ practices.

  5. Assures that the department meets all local, state, and federal regulatory guidelines, including JCAHO, Medicare, Medicaid, OSHA, and HIPAA requirements.

  6. Participates in and provides leadership for the development of policies and procedures for department, and organization.

  7. Responsible for resolution of patient and physician concerns related to Case Management Services.

  8. Contributes to organizational teamm project efforts and community relations.

  9. Models and coaches staff in consistent achievement of the Service Care Standards.

  10. Must be able to complete the physical, sensory and mental requirements of the position.


Position Specific Responsibilities:

  • Monitors and assures the daily activities of the Case Management staff are prioritized to achieve excellence in utilization management outcomes based on the current inpatient population.

  • Identifies and implements best practice strategies related to quality outcomes in conjunction with effective utilization of resources for patients, from admission to discharge.

  • Implements strategies to assure optimal assignment of patient status. (Inpatient, Outpatient, Observation and Same Day Care)

  • Collaborates with the CNO and Nursing leaders to implement strategies and achieve measurable goals that assure patient admissions meet medical necessity criteria, that the appropriate level of care (and resource utilization) is assigned and that attention is paid to high levels of patient satisfaction.

  • Responsible for monitoring and reporting utilization management outcomes, analyzing the data for trends, patterns and implementing PI strategies to achieve targeted outcomes.

  • Responsible for developing expertise and consistency in knowledge of the staff related to case management, utilization principles, quality outcomes and discharge planning.

  • Responsible for collaborating with the Compliance Officer, Director of Finance, HIM Director and staff to assure compliance to all regulatory standards.

  • Continually evaluates processes established for length of stay management and care efficiencies.

  • Ongoing Identification of opportunities for resource utilization improvements.

  • Assure physician education (one-on-one and in a more formal manner if needed) is provided to the medical staff on utilization management (LOS, etc) resource consumption opportunities.

  • Collaborates in Clinical Pathways development with the Nursing leaders, leaders of clinical guideline development teams and the Medical Staff as needed to assure pathways are aligned with best practice benchmarks and to assure utilization management outcome results are achieved.

  • Collaborate with Nursing leaders to identify key competency needs of nursing staff to enhance their recognition, understanding and knowledge of case management principles.

  • Additional duties may be assigned by the CNO.


Qualifications:

  1. BS or BA Degree, Nursing or business focused healthcare degree. Masters Degree preferred.

  2. Relevant leadership experience in a like size or larger organization required.

  3. Certification in Case Management required, but can be obtained within 2 years of hire.

  4. 3-5 years Case Management experience required in a hospital environment.

  5. Strong interpersonal and engagement skills.

  6. Demonstrated leadership skills.

  7. Demonstrated experience in project management and data driven, analytical performance improvement skills.

  8. Able to manage multiple priorities.



Working Conditions:

Potential exposure to Latex products, blood borne pathogens, hazardous materials, and communicable diseases.

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