Care Management Outcomes Optimization Specialist

Job Description:

The Care Management (CM) Outcomes Optimization partners with multiple care site and system leaders to ensure local and Enterprise Care Management is supported in staff development, outcomes, and quality. This position implements and evaluates care management systems and processes, serves as care manager advocate, leader, consultant, and change agent. The caregiver performs routine Q/A clinical audits, analyzes data, and identifies opportunities for improvement to offer competency development. This position participates in the development of policy, procedures, guidelines, process flows, audit tools, and the staff development plan. They act as the facilitator to new hires including orientation, schedule and oversite of precepting, and Q/A for new hire compliance. This position provides care management competency development to ensure a high-quality program and continuous process improvement model are executed. Participates in organization wide initiatives as a member of the leadership team.

Scope

• A clinical expert whose primary focus is to collaboratively support clinical excellence across care sites with integration of best and evidence based care management practice, including regulatory compliance, in order to support high performance clinical and financial outcomes.
• Implements and evaluates care management systems and processes, serves as care manager advocate, leader, consultant, and change agent.
• Responsible and accountable for care management standards of practice, and program and staff development.
• This role shares accountability with other members of the care management leadership team for designated systems utilization and performance outcomes.
• Participates in organization wide initiatives as a member of the leadership team.
• As the subject matter expert in their area of specialty, collaborates with care management leadership to assess, develop, and implement staff development and competency programs.
• Ensures staff competencies, practice patterns, and care coordination processes to achieve highest quality patient and department outcomes.
• Functions as an expert clinician, role model, educator, mentor for clinical staff. Identifies staff strengths and opportunities for development through learning needs assessments and structures experiences for staff members continual learning.
• Serves as a resource to new staff and preceptors in the orientation process. Provides input and may lead development of evidenced based policies, procedures, practice standards, quality improvements, and programs based on care management practice and regulatory standards, and identified opportunities.
• Utilizes data, processes, tools, and communication vehicles to support outcome monitoring.
• Takes action to continually improve the effectiveness of care management clinical practice and initiatives based on these outcomes.
• Participates in organized professional activities and applies new knowledge to development of educational design and instructional materials to support/improve clinical competencies.
• Maintains responsibility for updating and developing care management competencies in collaboration with peers across the Intermountain continuum. Responsible for oversight of orientation, mentoring, and tracking the progress of new hire care managers.
• Continually develops knowledge and skills in designated service area(s). Maintains care manager competency and licensure in clinical licensure area. May be required to perform in a primary care management role at designated clinical sites within the scope of qualifications and business need.

Minimum Qualifications

• RN: Bachelors Degree in Nursing from an accredited program is required.
• RN: Current valid State RN License is required.
• Social Worker: Masters Degree in Social Work from an accredited program is required.
• Social Worker: Current valid LCSW or LMSW license or SWLC required at hire with LCSW required within 4 years of employment or LMSW required within 2 years of employment.
• Ten (10) years of experience working in an acute or ambulatory healthcare setting
• Five (5) years of experience in Care Management role

Physical Requirements:

Physical Requirements

Interact with others requiring employee to verbally communicate as well as hear and understand spoken information. Operate computers, telephones, office equipment, and manipulate paper requiring the ability to move fingers and hands. See and read computer monitors and documents. Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment

Location:

Good Samaritan Hospital, Lutheran Medical Center, Platte Valley Hospital, Saint Joseph Hospital