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Manager of Medical Staff
2 months ago
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke University Hospital
Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.
Manager, Case Management
The Manager reports directly to the Assistant Director of the Case Management Department and provides direct supervision and oversight of the Case Managers (CMs) and Clinical Social Workers (CSWs ) who function within the inpatient and outpatient settings. The Manager is responsible for operationalizing Case Management and Clinical Social Work workflow standards and processes, ensuring adherence to regulatory guidelines and ensuring operations are consistent with DUHS organizational standards.
Partners with CM Director, Assistant Directors and Managers in conducting leadership rounds to support workflow and staff engagement.
~ Development and oversight of UM work schedules/calendar management via API in accordance with the PTO policy.
~ Ensure adherence to all Case Management Department and DUHS organizational policies.
~ Ensures adherence to regulatory compliance.
~ Attends and contributes to the Utilization Management Committee meeting.
~ Will participate in the development and presentation of projects and education topics to designated departments, provider groups, clinical service units and community collaborators as indicated.
~ Collaboration with CSU leadership on continuous process improvement
~ In collaboration with the Directors and Human Resources, manages the recruitment, hiring, onboarding and retention of Case Management Department staff.
~ Provides education to support regulatory compliance in collaboration with DUHS Compliance and CM Department leadership.
~ Conducts Utilization Management Divisional Meetings.
~ Monitors monthly reporting including but not limited to UM productivity, Readmission Documentation, Initial Time to Review, Avoidable Days Documentation, Denials Management and Discharge Appeals processes. Works with the Physician Advisors and Medical Directors on escalation of care and process improvement activities including but not limited to LOSM, readmissions, avoidable days, denial management, problem solving and education needs.
~ Participates in the review and updating of Case Management policies. - Experience withcare coordination, discharge planning, clinical information documentation and Utilization review.
PC proficiency and experience with care management workflow systems, such as Canopy Knowledge of InterQual criteria and patient status change Strong communication and leadership skills Knowledgeable of JCAHO, federal and state standards/regulations.
Considerable knowledge of large-scale health care facilities, policies, and issues.
Considerable knowledge of clinical protocols and practice management requirements in assigned area.
Ability to analyze data and employ approved management techniques and statistical tools to obtain maximum effectiveness, efficiency,
Ability to interpret established policies into operating procedures and to execute case management programs.
Ability to direct, instruct and advise staff in the approved methods, procedures and practices employed in effective health care administration
Ability to receive and effectively react to day-to-day problems presented by staff as well as others Knowledge of accreditation standards, health care regulations, performance improvement, patient safety and policy formulation.
Effective organizational, oral and written communication skills, problem solving, program development, computer skills, strong leadership, and team building skills.
Ability to work with a variety of disciplines and levels of staff across departments and the health system is required.
Knowledge of payer requirements and discharge planning regulations that support the effect development of departmental policies, procedures and standards Ability to establish priorities, meet deadlines, develop and manage the department's productivity standard in the management of the work assignment
Ability to form positive, collaborative relationships with members of the executive team, hospital staff, post-acute providers and payers
3-5 years of relevant management and Case Management experience
MANAGER, CASE MANAGEMENT
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.