Care Management Leadership Position

4 weeks ago

Kenosha, Wisconsin, United States Advocate Health Full time
Care Management Leadership Position

At Advocate Health, we are seeking a highly skilled and experienced Care Management Leadership Position to join our team. As a key member of our leadership team, you will be responsible for providing leadership and oversight of the Care Management and Social Work program and staff for our Aurora Medical Center Kenosha location.

Key Responsibilities:

  • Provide management oversight of the daily operations of the care management and social work programs at the assigned site(s). Approve and monitor staff schedules, paid time off, and time cards to ensure continuity of services.
  • Monitor proficiency of each site CM/SW staff and includes action plans to improve deficiencies, meet regulatory requirements, and drive efficiencies. Responsible for team building and conflict resolution.
  • Facilitate performance improvement activities for the care management program; assists to establish measures, performance targets, and benchmarks to drive achievement of established goals and achieve efficiencies of processes.
  • Identify and discuss overall and individual physician trends related to care management activities with Director of Inpatient Care Management Operations, Physician Advisor and site Medical Staff Leadership as appropriate with a documented improvement plan to include strategies and educational needs identified.
  • Serves as an internal consultant on Care Management opportunities. Acts as an expert resource for care management program, including evaluation of challenging cases, intervening with physicians when necessary, meeting with patients and families, dissemination and interpretation of key regulatory requirements and changes, etc.
  • Accountable for site care management/social work budgets as assigned. Develops and recommends operational and capital budgets and controls expenditure within approved budget objectives.
  • Ensures the care management/social work program operates within compliance of CMS, OSHA, Accrediting Organizations, and established care management practice standards and code of ethics.
  • Responsible for orientation, and ongoing competency assessment of CM/SW staff in collaboration with the Director of Inpatient Care Management Operations.
  • Responsible for personal professional growth. Participates in professional organizations, maintains license and certification as required, maintains effective working relations with both internal and external customers.

Requirements:

  • Registered Nurse license issued by the state in which the team member practices, or Social Worker license issued by the state in which the team member practices.
  • RN or SW: Accredited Case Manger (ACM) or SW (ACM) certification issued by the American Case Management Association (ACM) needs to be obtained within 1 year, or RN or SW: Certified Case Manager (CCM) issued by the Commission for Case Manager Certification (CCMC) needs to be obtained within 1 year, or RN: Nursing Case Management (RN-BC) certification issued by the American Nurses Credentialing Center (ANCC) needs to be obtained within 1 year, or SW: Certified Social Worker in Health Care (C-SWHC) issued by National Association of Social Workers to be obtained within 1 year.
  • Bachelor's Degree in Nursing or Master's Degree in Social Work.
  • Typically requires 5 years of experience in a relevant clinical setting. Includes 1 year of supervisory experience in a Care Management Leadership role.

Preferred Qualifications:

  • Master of Nursing Administration, Master in Health Care Administration or related field preferred.
  • Ability to prioritize and organize work.
  • Ability to travel and work across multiple sites as assigned (IL or WI).
  • Effective communication skills.
  • Utilization of critical thinking in timely decision making.
  • Knowledge of MS Office products.
  • Demonstrates leadership skills.
  • Knowledge of Medicare A and B guidelines.
  • Knowledge of Managed Care programs/requirements/implications.
  • Knowledge of Conditions of Participation for Discharge Planning.
  • Knowledge of requirement elements of Utilization Management program, including support of the UM Plan.
  • Knowledge of Regulatory environment.
  • Ability to work autonomously and respond to multiple requests effectively.

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