Assistant Manager Care Manager, Care Coordination - Full-Time, Days - The University of Chicago Medicine

Job Description

Be a part of a world-class academic healthcare system at UChicago Medicine Ingalls Memorial Hospital as a Assistant Manager Care Manager in the Care Coordination department. Here, you are part of a multidisciplinary team, including physicians, and payers, ensures the patient’s progress in the acute episode of care through post discharge and is quality driven while being efficient and cost effective. This position is a 100% onsite opportunity. You will need to be based in the greater Chicagoland area.

The Assistant Manager works with the attending and consulting physicians to facilitate effective and efficient transition through the process of hospitalization. The Assistant Manager works collaboratively with all members of the multi-disciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum, as well as appropriately reimbursed by payers as contracted. The Assistant Manager seeks the expertise of social workers to resolve psychosocial patient care issues and to develop complex patient transition/discharge plan as needed. The incumbent interacts with patients, family members, healthcare professionals, community, and state agencies in this effort. The Assistant Manager serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information. The Assistant Manager is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) series and CMS guidelines. In addition, the Assistant Manager provides case review information to third party payers, assists in the denial and appeals process, and assesses quality, levels of care, and reporting potential risk management issues. The incumbent performs duties and tasks in accordance with performance standards established for the job. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position. The incumbent conducts all job responsibilities according to the Mission, Vision and Values of the Hospital.

Essential Job Functions

• Reviews patient charts daily or as needed
• Utilizes MSW Social Worker for appropriate referrals: patient/families with complex psychosocial, on-going medical discharge planning issues, continuing care needs and end of life issues
• Attends care rounds daily, or per unit policy
• Communicates targets and identified standards of care through collaboration with multidisciplinary team to reduce LOS and inappropriate resource consumption
• Collaborates with patients, families and other members of the interdisciplinary team as needed
• Insures that all critical elements of the care and discharge plan are communicated to the multi-disciplinary team, patient and family including expediting teaching needs
• Identifies plans and facilitates strategies to reduce length of stay and inappropriate resource consumption, working in collaboration with attending and consulting physicians
• Initiates discharge plan within 24 hours of admission
• Initiates a targeted discharge date/time within 24 hours of admission, where appropriate
• Provides and updates multi-disciplinary team through medical record documentation and pre-defined communication/points of contact regarding potential or planned discharges (e.g., bed meetings)
• Provides and updates referrals to facilities or agencies through online/software discharge planning tools
• Reviews and completes all appropriate information accompanying patient facility or agency
• Acts as a liaison between hospital and post-acute facilities or agency to facilitate returns/admissions
• Facilitates arrangements for time and mode of transportation to facilities for patients
• Arranges and participates in care conferences with unit staff, home care staff, patients and/or families
• Provides adequate avenues of communication through on-going documentation in appropriate systems and telephone/verbal reporting or electronic tools
• Coordinates and communicates with home care agencies regarding expected standards of care for requested specific treatments
• Identifies and provides information on requested procedure or medicines
• Discusses specific continuing care needs with physicians and hospital personnel on a regular basis
• Collaborates with other inter disciplinary team members as needed
• Monitors the completion of forms for transfers to nursing facilities, as required
• Participates in departmental and hospital Quality Improvement programs, as directed
• Documents disposition of patient at discharge
• Provides adequate documentation of initial assessment and on-going clinical progress in appropriate system and reviews all referrals for accuracy and content prior to discharge
• Accepts responsibility for further development of professional learning and growth
• Actively participates in interdisciplinary projects using the Quality Improvement plan
• Conducts inpatient admission reviews for appropriateness of setting, admission status (IP/OP) and level of care (intensive care, general care)
• Conducts on-going case review for continued stay criteria and enters data
• Monitors quality of care using predetermined criteria
• Reports potential risk and/or quality management issues identified from medical record review to appropriate departments through defined processes
• Enters data as requested and appropriate for role, to support Quality Improvement initiatives into appropriate system
• Using approved medical necessity criteria, conducts admission and continued stay review to ensure appropriateness of the setting and timely implementation of the plan of care, to monitor the patient’s progress along the continuum of care and intervenes as necessary to ensure appropriateness of setting and that the services provided are quality, efficient and cost effective
• Consults with Physician Advisor or defined medical staff role (e.g., Attending, Flow Director) as necessary to resolve barriers through appropriate administrative and medical channels to avoid third party payer denials
• Responds in a timely manner to all requested insurance reviews involving admissions, continued stay, and discharge planning as well as contact for onsite reviewers to confirm hospital will be paid for services provided as contracted
• Documents in appropriate electronic system by the close of business each day
• Communicates with admitting and pre-certification regarding level of care status.

Required Assistant Patient Care Manager Qualifications

• Graduation from an accredited school of nursing with a Bachelor of Science in Nursing (BSN) is required
• Must hold a current RN Licensure State of Illinois Department of Professional Regulation or valid temporary permit to practice nursing in the State of Illinois
• Must hold a current Basic Life Support certification (Healthcare Provider Recognition)
• 3-5 years of experience in RN specialty area

Preferred Assistant Patient Care Manager Qualifications 

• Prior leadership experience

Position Details

• Job Type/FTE: Full-time (1.0); 8-hour shifts
• Shift: Days
• Work Location: Onsite
• Unit/Department: Care Coordination 
• CBA Code: Non-Union

Why Join Us

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

UChicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: UChicago Medicine Career Opportunities.

UChicago Medicine is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.

Must comply with UChicago Medicine’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.

Compensation & Benefits Overview

UChicago Medicine is committed to transparency in compensation and benefits.  The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.

The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.

Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.