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Inpatient Care Management Supervisor
2 months ago
POSITION SUMMARY
The Inpatient Care Management Supervisor will oversee and guide all levels of the Care Management team, which includes RN Care Managers, Lead CM RN, CM Coordinators, Discharge Planners, Care Coordinators, Inpatient CM Supervisor, Complex CM Team, CM Educator, and UM CM Staff. This role may also involve supervising and providing coverage for other management within the Care Management Department. Responsibilities encompass patient assessments for care levels, appropriateness for admission or observation, HLOC transfers, discharge assistance, and follow-up care in collaboration with the Emergency Department and Social Work care management team. The Manager will initiate, review, and implement Care Management policies as necessary.
This supervisory role will also provide clinical oversight for scheduling, payroll management, coaching, corrective actions, and educational needs to ensure adherence to Care Management policies and processes within the organization. The position will manage the electronic referral system, documentation through Cerner Healthcare EMR, and collaborate with Clinical Informatics to enhance CM documentation and handoff processes.
Responsibilities include overseeing post-acute providers, facilities, and community service providers as directed by the Senior Director of Care Management, Social Work & Transitional Care. The Manager will assist in overseeing compliance policies related to vendor networks, maintaining effective relationships between the organization and individual network providers. Identifying opportunities to enhance post-discharge services to minimize readmissions and improve community health will be a key focus, in collaboration with other CM Managers.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Supervises the IP CM RNs, CM Coordinators, Care Coordinators, Discharge Planners, CM Educator, IP Supervisor, and UM team to support the Care Management services, including assessments, transfers to HLOC, inpatient discharge needs, and follow-up care.
- Collaborates with the Manager of ED CM & Transitional Care and the Director or Supervisor of Social Work Services to support the Care Management Program and the Population Health Program.
- Ensures compliance with policies related to discharge planning and manages agreements with post-acute networks.
- Assesses the need for additional provider networks in collaboration with management based on clinical and social needs.
- Identifies and evaluates potential post-acute service providers.
- Participates in hospital committees and multidisciplinary conferences, as well as staff meetings for the Care Management department.
- Models leadership and promotes professionalism to assist staff in developing teamwork and flexibility.
- Ensures accountability for performing initial assessments, documenting discharge plans, and collaborating for safe patient discharges.
- Oversees the hiring process and recommends staffing needs to meet population requirements.
- Manages payroll and monitors attendance in accordance with HR policies.
- Oversees various clinical, operational, and business projects aimed at reducing readmissions and improving transportation services.
- Works closely with ED Care Coordinators, Case Managers, Social Work, and clinical staff to ensure seamless patient transitions to post-acute providers.
- Establishes and monitors management metrics related to quality, outcomes, and productivity, providing scheduled reports to the Senior Director of Care Management.
- Designs and coordinates training for staff and providers regarding post-acute services and oversees the clinical education program.
- Continuously evaluates and addresses internal and external customer concerns.
- Coordinates services and meetings with health department staff and outpatient clinics to ensure smooth transitions for patients.
- Collaborates with CM Leadership to ensure adequate staffing and scheduling for transitional care functions.
A. Education
- Bachelor's degree in nursing required; Master's degree in nursing or related field preferred.
- Five (5) years of experience in acute care hospital, health plan, or ancillary services required.
- Prior supervisory or management experience in a clinical role required.
- RN license required; CCM or ACM certification required within two years of hire.
- Basic Life Support (BLS) certification required.
- Experience with Medicaid/Medi-Cal patients and government programs preferred.
- Experience in clinical health informatics preferred.
- Significant knowledge of healthcare provider organizations, including acute and post-acute care facilities.
- Working knowledge of health plans and typical utilization management functions.
