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Manager Inpatient Care Management
4 months ago
if you are interested please apply online and send your resume to NOrozco@mlkch.org
POSITION SUMMARY
The Manager of Inpatient Care Management will supervise and direct all levels of Care Management team that includes RN Care Managers, Lead CM RN, CM Coordinators, Discharge Planners (DCP), Care Coordinators Inpatient CM Supervisor, Complex CM Team, CM Educator, and UM CM Staff. This position may also be asked to supervise and cover supervision for other management in the CM Department. These services include assessment of patients for level of care, appropriateness for admission or observation, HLOC transfers, discharge assistance, and follow up care as appropriate in collaboration with the ED and SW care management team. Care Management policies for this work initiated, reviewed and implemented by the Manager as needed.
This Manager role will also provide clinical supervision for scheduling, UKG Pro payroll, coaching/corrective action, and educational needs to ensure that the Care management policies and processes are carried out for the organization. This role will oversee the electronic referral system, currently Ensocare, documentation of CM through Cerner Healthcare EMR including working with Clinical informatics (CIT), to develop or improve CM documentation, as well as handoff processes such as Caringly tool.
This position is responsible for overseeing post-acute providers, facilities and other types of community service providers as directed by the Senior Director of Care Management, Social Work & Transitional Care. The manager will assist with overseeing compliance policies and plan related to vendor networks to maintain a working relationship between MLK and individual network providers. Manager will identify opportunities to improve post discharge services to reduce readmissions and improve community health in collaboration with other CM Managers (SW & ED/Transitional Care). May make decisions related to transportation and sign take back agreements with other hospitals as delegated by the Senior Director.
Works collaboratively with other managers within the Population Health Program to support the entire Care Management Department. This role is expected to share in CM Leadership Call on a rotation basis as assigned by the Senior Director for Care Management
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Manages and supervises the IP CM RNs, CM Coordinators, Care Coordinators,
Discharge Planners, CM Educator, IP Supervisor, and UM team to support the MLKCH CM services includes but not limited to assessments, transfers to HLOC, IP discharge needs, and follow up care by DCP team according to CM Department policies and procedures. - Works in collaboration with the Manager of ED CM & Transitional Care and Director or Supervisor of Social Work Services to support the Care Management Program as well as in support of the Population Health Program at MLKCH.
- Oversight of MLKCH compliance policies related to discharge planning and use of letter of agreements (LOA) with current/planned scope of post-acute networks including:
- MLK-LA Skilled Nursing Facilities (SNF)
- MLK-LA Home Health Professional Network (planning)
- MLK-LA Palliative and Hospice Network (planning)
- Have oversight of assessing need for additional provider networks in collaboration with management given new clinical/social needs and ongoing revisions to the Population Health Strategy by working with the post-acute coordinator and the ED CM & Transitional Care Manager.
- Identify and vet potential post-acute service providers
- Participates in hospital committees and unit specific multidisciplinary conferences as well as staff meetings for the Care Management department
- Models leadership and promotes professionalism to assist staff in developing priority setting, team work, and flexibility in support of the Care Management team and in community health activities.
- Holds clinical and non-clinical staff accountable for the performing initial assessments, identifying and documenting a discharge plan, and collaborating with the work team to ensure a safe patient discharge under the scope and standards for ACMA & CMSA standards.
- Responsible for the hiring process and identifying and recommending staffing needs with skill mix as appropriate to meet needs of the population.
- Manages payroll in UKG Pro; monitors overtime as well as attendance related to HR policy for time & attendance.
- Oversee a mix of clinical, operational and business projects including but not limited to ones used reduce readmissions, improve transportation services such as ambulance services, and other clinical services
- Work closely with and in partnership with ED Care Coordinators, ED Case Managers, Social Work, TCN staff, and clinical staff to ensure that patients care transitions from MLK entities to post-acute network providers are seamless.
- Establish and monitor management metrics: quality, outcomes, productivity of staff work, financial, case volume/mix and provides scheduled reporting to the Senior Director of CM.
- Design and coordinate formal and informal training for staff and providers regarding post-acute services case management services, and oversees the clinical education program executed by the CM Educator.
- Systematically and continuously evaluate and address internal and external customer concerns/ grievances
- Collaborates and coordinates services and joint meetings with LA Department of Health Outpatient Clinic staff
- Collaborates and coordinates functional programs with MLKCH Outpatient Clinics to ensure smooth transitions to community healthcare for MLKCH patients.
- Collaborates with other CM Leadership to ensure adequate staffing and scheduling to support the functions of the transitional care team.
POSITION REQUIREMENTS
A. Education
- Bachelor degree in nursing required. Master degree in nursing or related area preferred
- Five (5) years acute care hospital, health plan, and/or ancillary services required.
- Prior Supervisory or Management Experience in a clinical role required.
- RN license required; CCM or ACM certification required within 2 years of hire
- Basic Life Support (BLS) certification
- Workplace violence prevention annually.
- Direct patient care or care coordination, utilization, case/disease management experience a plus
- Experience with Medicaid/ Medi-Cal patients and government programs preferred
- Experience in clinical health informatics is preferred.
- Significant knowledge regarding health care provider organizations - acute and post-acute care facilities and providers
- Working knowledge of health plans and typical UM and medical management functions
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