Manager of Case Management Department, 40 hours, day shift - Heywood Hospital

ESSENTIAL FUNCTIONS

Management

Provides coaching and education for staff so that they can meet/exceed performance expectations, such as:

• Develop and implement performance improvement plans in collaboration with the Director.
• Provide constructive feedback to employees.
• Ensures that employee skills match job requirements.
• Completes all employee performance evaluations by evaluation due dates.

Oversees daily operations to meet the vision of providing service to the community, such as:

• Improves patient and/or customer satisfaction.
• Responds to customer requests and concerns in a timely and effective manner.

Meets/exceeds customer expectations so that the customers select and recommend Heywood Hospital as their primary source of healthcare, such as:

• Utilizes customer satisfaction data to develop and anticipate customer service systems.
• Staffing patterns and work flow design match customer requirements.

Manages resources to ensure adequate resources and future growth, such as:

• Develops and maintains department budget in conjunction with the Director. Monitors OT and justifies variances to the budget.
• Review and approval payroll weekly.
• Interviews, hires, and onboarding new staff.
• Reduces costs and/or increases revenues.

Collaborates/coordinates projects/activities with other departments, teams, and task forces to build a team approach to healthcare delivery, such as:

• Participates on task forces, PI teams, committees, etc.
• Leads task forces, PI teams, committees, etc.

Manager of Case Management

• Acts as a resource for the care transitions department.
• Demonstrates the clinical expertise necessary to perform as a role model for staff. Provides feedback to staff during daily rounds concerning: level of care, ABN/HINN notices, and care progression.
• Lead and direct all case management and social services activities, ensuring patient care coordination and adherence to clinical protocols and regulatory standards.
• Reviews department clinical services and operations, and tracks case management and social services activity. Identifies areas for performance improvement by examining productivity and workload within each department. Coaches, mentors and assesses staff in service delivery.
• Develops and implements Utilization Review based on internal data collection, data received from external agencies, physician advisors and the medical director. Analyzes appropriateness of resource utilization and communicates findings.
• Maintains necessary levels of staff qualifications, competencies, staffing levels, regulatory compliance, individual development plans, continuing education and performance appraisal.
• Manages resource use and provides input to Director regarding expense and revenue decisions. Monitors outcomes and staffing needs to adequately allocate personnel resources.
• Ensures department achieves goals and objectives by developing scope of service and policies/procedures, establishing/maintaining effective relationships with physicians/APPs, and collaborating with other disciplines. Assesses goals and utilizes data to effect corrective action.
• Ensures appropriateness of admissions and proper reimbursement. Works collaboratively with finance.
• Ensures proper discharge planning for a smooth transition post-acute care.
• Reviews and presents data relative to avoidable days, denials, length of stay and other key metrics to leadership.
• Perform internal audits to ensure compliance with organizational and state/federal practices, policies, and regulations.
• Assists Director with developing and/or revising policies and procedures to comply with regulations and best practice.
• Other duties as assigned.

Statement of Other Duties

This document describes the major duties and responsibilities for this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described.

Organizational Expectations

Behavioral Attributes

The following behavioral attributes are required: achievement, motivation, flexibility, concern for order, initiative, self-confidence, self control, and customer service orientation, interpersonal effectiveness, analytical and information seeking.

Functional Demands

Physical Requirements

Exerts up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. Frequently reaches (extending hands and arms in any direction), and handles (seizing, holding, grasping, turning, or working with hands).

Job Requirements

Minimum Education

• BSN required or must matriculate within 1 year of hire; MSN preferred.

Minimum License and Certifications

• Registered nurse required with an active Massachusetts license
• Case Management Certification preferred

Minimum Work Experience

• Previous management experience required
• Five or more years of case management experience
• Minimum 3 years of Acute Care Inpatient Case Management experience required

Required Skills

• Previous UR/QA experience required
• InterQual experience preferred.
• Must have effective written, verbal, and interpersonal communication skills
• Discharge planning experience as it pertains to the care transitions, referral process, patient preference/choice services, patient & family satisfaction, post-discharge follow-up, etc.
• Provides administrative and Swing Bed admission oversight responsibilities; leadership experience a plus.