Manager of Care Management

Department:

11200 AMC Kenosha - Case Management

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

Monday-Friday normal business hours

On Call for emergent needs

Pay Range

$46.55 - $69.85

Provides leadership and oversight of the Care Management (CM) and Social Work (SW) program and staff for the Aurora Medical Center Kenosha. Provides direct management and development of site CM/SW staff. Collaborates frequently with Hospital Leaders, Post-Acute Partners, Physicians, Physician Advisors, Nurses, and others to ensure accurate and timely progression of care, discharge planning, and compliance with regulatory standards/conditions of participation related to discharge planning and utilization management. Supports ongoing communication and education on care coordination, discharge planning, alternate payment methods, regulatory requirements and performance improvement methodologies.

Major Responsibilities:

• Provides management oversight of the daily operations of the care management and social work programs at the assigned site(s). Approves and monitors staff schedules, paid time off, and time cards to ensure continuity of services. Monitors proficiency of each site CM/SW staff and includes action plans to improve deficiencies, meet regulatory requirements, and drive efficiencies. Responsible for team building and conflict resolution.
• Facilitates performance improvement activities for the care management program; assists to establish measures, performance targets, and benchmarks to drive achievement of established goals and achieve efficiencies of processes. Collects, analyzes, and reports data to measure and identify the effectiveness of care processes and variations from standards and expectations. Analyzes data and information to discern root causes of performance gaps using key data and reports.
• Identifies and discusses overall and individual physician trends related to care management activities with Director of Inpatient Care Management Operations, Physician Advisor and site Medical Staff Leadership as appropriate with a documented improvement plan to include strategies and educational needs identified. Regularly reviews individual site successes and improvement opportunities with the Director of Inpatient Care Management Operations, site leadership and other key stakeholders.
• Serves as an internal consultant on Care Management opportunities. Acts as an expert resource for care management program, including evaluation of challenging cases, intervening with physicians when necessary, meeting with patients and families, dissemination and interpretation of key regulatory requirements and changes, etc. Consults, communicates, and organizes key ongoing education, serves as a supportive member of site UM Committees, and/or other site meetings as appropriate. Participates in multidisciplinary cross functional efforts to ensure high quality, cost effective coordinated care. Works collaboratively with Physician Advisor(s) on challenging cases, removing barriers to discharge.
• Accountable for site care management/social work budgets as assigned. Develops and recommends operational and capital budgets and controls expenditure within approved budget objectives.
• Ensures the care management/social work program operates within compliance of CMS, OSHA, Accrediting Organizations, and established care management practice standards and code of ethics. Collaborates with Compliance to ensure care management/social work program meets all state and federal guidelines.
• Responsible for orientation, and ongoing competency assessment of CM/SW staff in collaboration with the Director of Inpatient Care Management Operations.
• Responsible for personal professional growth. Participates in professional organizations, maintains license and certification as required, maintains effective working relations with both internal and external customers. Maintains required competencies and assumes responsibility of personal development and maintenance of ongoing workshops, conferences, and/or in-services and maintaining records of participation.
• Performs human resources responsibilities for staff which include interviewing and selection of new employees, promotions, staff development, performance evaluations, compensation changes, resolution of employee concerns, corrective actions, terminations, and overall employee morale.
• Develops and recommends operating and capital budgets and controls expenditures within approved budget objectives.
• Responsible for understanding and adher