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Nurse Manager, Care Management
3 months ago
POSITION SUMMARY: Responsible for promoting and maintaining quality patient care through effective management and coordination of Care Management, Utilization Review and Social Work services at MMH and RGH as well as provide oversight to the Observation Services program in the ED, Patient Care Unit (PCU), and medical surgical areas. Allocates available resources to promote efficient, effective, and compassionate patient care and discharge planning. Provides clinical and administrative leadership and expertise.# Facilitates an atmosphere of participative management and the development of collegial relationships. Is visible, accessible and committed to communicating effectively with staff.# Promotes the professions of nursing and social work in their professional practice. Represents the organization in a positive and professional manner.# This position is required to travel among ECHN facilities and to professional meetings within the state. Reports to the Administrative Director of Care Management. EDUCATION/CERTIFICATION: Bachelor#s degree and a graduate of an accredited school of Nursing. Must have and maintain a current Registered Nurse license with the State of Connecticut. Masters# degree or evidence of current enrollment in an accredited program is strongly preferred. Professional certification in case management is strongly preferred. Must have a valid driver#s license for travel between ECHN business sites. EXPERIENCE: Must have at least five (5) years experience in clinical nursing, including (3) years of experience in hospital case management and Clinical experience in acute care, home care and/or long-term care with demonstrated leadership potential.# COMPETENCIES: Must be able to communicate effectively in English, both verbally and in writing, possess basic computer skills and have good analytical, organizational, and interpersonal skills.# Knowledge of continuity of care including health care systems, reimbursement systems and regulations that pertain to areas of responsibility. ESSENTIAL DUTIES and RESPONSIBILITIES: Disclaimer: Job descriptions are not intended, nor should they be construed to be, exhaustive lists of all responsibilities, skills, efforts or working conditions associated with the job.# They are intended to be accurate reflections of the principal duties and responsibilities of this position.# These responsibilities and competencies listed below may change from time to time. Job-Specific Competency Provides administrative support to the Administrative Director of Care Management.# Participates and facilitates staff participation in department and organizational policy formulation and decision making. Provides oversight to the ED and Scatter Bed Observation Services program, including education of staff about criteria and documentation requirements. Works with Care Managers to prevent denial of coverage, when possible, and to successfully appeal payment denials. Creates an environment which promotes the provision of high-quality, evidence based clinical practice by Care Managers and Medical Social Workers. Works in conjunction with the Physician Advisor and Administrative Director of Care Management to carry out objectives of the Medical Management Plan as evidenced by regular attendance and active participation at Medical Management and Care Management meetings and projects. Evaluates the quality and appropriateness of care management.# Participates in quality improvement projects and initiatives.# Performs necessary data collection, audits and analysis related to quality and regulatory compliance, as requested by ECHN committees and outside agencies. Advocates for patient access to and choice of services during hospitalization and post discharge.# Serves as a liaison with Skilled Nursing Facilities, Home Care agencies and Medical Equipment providers to promote a smooth transition of care.### Follows protocol for responding to patient complaints and grievances. Is responsible for staffing and scheduling personnel.# Assignments reflect appropriate utilization of personnel. Promotes staff satisfaction through a participative practice environment, encouraging staff decision making and autonomy.# Feedback from staff is encouraged, valued, and incorporated, as appropriate. Provides input to staff performance evaluations and monitoring of action plans. Whenever possible, resolves human resource concerns at the department level, utilizing the grievance process as required. Fosters a climate conducive to educational experiences and professional growth for all staff and students.# Objectively evaluates employees# performance and provides constructive feedback.# Identifies employees# potential for assuming additional responsibilities and fosters individual growth. Participates with nursing leadership in decisions about patient placement and care needs from a global hospital perspective, allocating resources accordingly and promoting efficient patient throughput. Demonstrates an ability to be flexible, organized, and functional under stressful situations.# Utilizes critical thinking skills and sound judgment in priority setting and delegation. Pursues personal and professional growth and development through participation in educational programs and review of current literature as evidenced by yearly educational and professional logs.# Serves as a professional role model and mentor.
