Care Management Leadership Role
4 days ago
Piedmont Newton Hospital seeks an experienced Care Manager to lead our Care Management department.
The ideal candidate will have a strong background in case management, with a minimum of 7 years of experience in an acute care setting and 3 years of management experience. A Bachelor's degree in nursing, social work, healthcare administration or related field is required. Unrestricted registered nurse (RN) license or licensed Master Social Worker (LMSW), or licensed Clinical Social Worker (LCSW) in the state of Georgia is also required.
A competitive salary for this role is estimated to be around $120,000 per year, based on industry standards and location.
About the Role:
- This role will provide performance improvement, operational, human resources and financial management of the Care Management department.
- It will ensure that Care Management services are delivered in accordance with evidence-based guidelines and established standards of care practice.
- The successful candidate will promote quality patient throughput in a resource/cost effective manner via effective care coordination and discharge planning.
- They will also ensure that department operations and delivery align with PHC and industry quality standards.
- In addition, they will effectively promote Care Management practices in software and IT systems.
- Responsibilities include analyzing metrics such as Average Length of Stay and Case Mix Index.
- The selected candidate will report on Care Management department with Chief Financial Officer.
- They will establish collaborative working relationships with hospital and PHC leadership.
- They will also work with Utilization Management and Revenue Cycle.
- Another responsibility is overseeing monitoring of staff utilization based on workload, skill level, acuity and economic constraints.
- The role requires participation in Director and Leadership activities for hospital and PHC.
- The successful candidate will actively participate in strategic planning.
- They will ensure a safe work environment for CM staff.
- Additionally, they will provide training and resources to staff within budgetary constraints.
- They will also ensure that staff are informed of departmental, hospital, PHC and general CM issues.
- Furthermore, they will delegate responsibilities to appropriate personnel.
- They will notify and consult with Risk Management as appropriate.
- The role involves providing leadership in recruitment and retention activities.
- They will implement Human Resources policies for performance plans and deployment.
- They will ensure that personnel and competency files are maintained in accordance with hospital, PHC and industry standards.
- Finally, they will perform outreach activities with community based provider practices and agencies.
Qualifications:
- Minimum education: Bachelor's degree in nursing, social work, healthcare administration or related field from an accredited school.
- Minimum experience: Seven years of case management or social work experience in an acute care setting, including three years of management experience.
- Comprehensive knowledge of the healthcare industry, care coordination, government regulations and healthcare plans.
- Experience using InterQual or Milliman preferred.
- Minimum licensure/certification: Unrestricted registered nurse (RN) license or licensed Master Social Worker (LMSW), or licensed Clinical Social Worker (LCSW) in the state of Georgia.
- Additional qualifications: Certification in Case or Care Management preferred.
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