Description
JOB PURPOSE OR MISSION
Under the supervision of the Director of Care Management, the Manager of Care Coordination will provide clinically oriented management of daily operations for the care coordination team. The manager will support the coordination of access to care, progression of care, and the transition of care from a wholistic patient perspective, understanding the department aim of resource utilization and throughput. The manager will lead the care coordination team to ensure quality and safety patient outcomes as they discharge from the acute setting and transition back into the outpatient management for continuing post-acute and community care. Performs all job duties for the age population served, as defined in the department's scope of service.
PERFORMANCE CRITERIA
CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.
PERFORMANCE STANDARDS:
• Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
• Takes initiative in living our Everyday Excellence values and vital signs.
• Takes initiative in identifying customer needs before the customer asks.
• Participates in teamwork willingly and with enthusiasm.
• Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
• Keeps customers informed, answers customer questions and anticipates information needs of customers.
CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines, and the GHS Corporate Compliance Guidelines.
PERFORMANCE STANDARDS
• Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
• Maintains accurate and reliable patient/organizational records.
• Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.
CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.
PERFORMANCE STANDARDS
• Uses accepted procedures and practices to complete assignments. Uses creative and proactive solutions to achieve objectives even when workload and demands are high.
• Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.
• Upholds the ethical standards of the organization.
CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.
PERFORMANCE STANDARDS
• Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.
• Initiates or redesigns to continuously improve work processes.
• Contributes ideas and suggestions to improve approaches to work processes.
• Willingly participates in organization and/or department quality initiatives.
CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
PERFORMANCE STANDARDS
• Effectively manages time and resources
• Makes conscious effort to effectively utilize the resources of the organization — material, human, and financial.
• Consistently looks for and uses resource saving processes.
CRITERIA F: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.
PERFORMANCE STANDARDS
• Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
• Employee proactively reports errors, potential errors, injuries or potential injuries.
• Employee demonstrates departmental specific patient and employee safety standards at all times.
• Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.
JOB FUNCTIONS
ESSENTIAL JOB FUNCTIONS include, but are not limited to:
1. Daily Operations (Maintains an organized department to ensure efficiency, accuracy of work, and information flow.)
PERFORMANCE STANDARDS:
• Provide frontline support, supervise daily activities, and manage the care coordination team to ensure performance and process accountability.
• Ensure collaboration of health care team members in capacity and resource decisions.
• Provide orientation and continued education for the care coordination team.
• Engage and communicate with team members who are needing additional help and support to effectively manage their role.
• Ensure that established goals, objectives, and departmental priorities are carried out daily and is consistent with the BRG philosophy.
• Takes a leadership role in organization/department initiatives to ensure success for patient flow and resource utilization.
• Review daily productivity and coordinate daily staffing needs for the care coordination team with regards to market/seasonal changes.
• Assist the Director of Care Management with employee talent management, performance evaluations, and performance improvement for the care coordination team.
• Works in collaboration with the Manager of UR to problem solve regarding complex patient care and organizational/operational issues.
• Demonstrate knowledge of current payor contracts, organizational policies/procedures, and regulatory changes by ensuring the high quality and safe standard of care.
• Review monthly expenses as assigned and assists with determination of expenses (e.g., contracts) in budget preparation.
• Ensure timely follow-up of incident reporting, including grievances.
• Participates in employee monthly rounding and preparing stoplight reports.
• Oversees all Krono's timekeeping transactions and monthly scheduling for the care coordination team.
2. Performance and Process Accountability (Participates in the development of departmental goals and objectives.)
PERFORMANCE STANDARDS:
• Establish and maintain effective working relationships by collaborating and communicating with members of the interdisciplinary team.
• Ensures that all policies and procedures are followed.
• Identify and communicate barriers to patient flow and capacity by reporting avoidable days/progression of care opportunities.
• Participate in team meetings and provide education and support to the department as it relates to progression and transitions of care.
• Identify performance improvement indicators and initiates monitoring and process improvement activities to ensure compliance.
• Collaborate with the quality department on readmission data and use proactive strategies to reduce readmission penalties in the organization, ensuring patient success in the outpatient setting.
• In collaboration with the Manger of UR, leads the Complex Outlier Patient Engagement (COPE) meetings by identifying complex stays, recommend proactive resources, and provide open discussions for immediate intervention.
• Assess and communicate resource information related to post-acute partners, insurance payers, bed capacity, and disasters to the organization and department.
• Assist in the review of departmental data analysis and compilation as necessary.
3. Care Coordination (Ensures assessments, interventions, and discharge of patients and families are provided timely and with sound clinical judgement.)
PERFORMANCE STANDARDS:
• Assist with the monitoring of discharge plans, communication with families, patients and other healthcare professionals, and utilization of community resources.
• Ensure that discharge planning conditions of participation are followed per the CMS guidelines.
• Compile audit reports from care coordination documentation for performance improvement and education.
• Carries out job functions associated with Care Coordination with staffing needs.
4. Performs other duties as assigned.
PERFORMANCE STANDARDS:
• Assist in arranging the disposition of bodies in the morgue.
• Collaborate and communicate with Coroner's office for morgue issues, as needed.
• Ensure all morgue actions are documented in the medical record.
Requirements
Current RN, LMSW, or LCSW licensure
1 year of leadership experience and 5 years of healthcare experience preferred.
SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS
Case Management Certification is preferred.
Knowledge of CMS Condition of Participation Guidelines
Current reimbursement models: Commercial, Managed Care, Medicare, and/or Medicaid
Clinical knowledge of evidenced-based clinical practice, clinical trajectories, and recovery patterns.
Healthcare law and regulations related to acute care and the immediate post-acute continuum.
Essential leadership, advocacy, communication, education and counseling, and resource research skills
Expertise in project management and training.
Strong analytic, data management, and computer skills
Effective verbal and written communication skills
Ability to manage multiple priorities.
HIPAA REQUIREMENTS:
Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to: Medical records without limitation both paper and electronic, patient demographics, lab and radiology results, patient information related to surgery or appointment schedules, medical records related to quality data, patient financial information, patient 3rd party billing, patient related complaints, information related to patient location, public health records, and/or patients religious beliefs.
SAFETY REQUIREMENTS:
Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: Incident reporting, handling of wasters, sharps and linen, PPE, exposure control plans, hand washing, patient identification, receives orders for patients, and monitoring clinical alarms.
Apply on company website
Find Connections via Linkedin
