Manager, Inpatient Case Management

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Manager of Care Management oversees the daily operations of the department in accordance with the mission and values of the institution while focusing on patient safety, quality, throughput and reimbursement. The Manager guides decision making and is a key contact person within the department of Care Management to assure compliance with all hospital and regulatory guidelines.

EEO/AA/Disability/Veteran

• 1. Human Resources/Managerial
• 1.1. Oversee the operational effectiveness of all staff, maintain individual accountability to job responsibilities and department standards, and intercede in a timely manner when necessary.
• 1.2. Develop and maintain team of highly skilled professionals who are effectively utilized to meet the department and organization?s goals.
• 1.3. Provide leadership and innovation by creating a shared vision and sense of purpose.
• 1.4. Ensure staff competencies are completed in all areas annually.
• 1.5. Provides constructive feedback to all staff seeking learning opportunities and supports the development of their personal goals.
• 1.6. Meets deadlines for performance review completion.
• 1.7. Directly responsible for personnel actions including but not limited to hiring, disciplinary action, staffing standards, and maintaining payroll records.
• 1.8. With the management team, develop yearly CM departmental goals with measurable outcomes.
• 2. Patient Satisfaction/Service Excellence
• 2.1. Lead with patient/family centered philosophy in mind and sets examples for staff to use in interactions with staff, patients and families.
• 2.2. Promotes and rewards atmosphere of respect and professionalism for all staff within and outside the department. Provides Service Excellence by creating a great first impression and meet standards of professional behavior.
• 2.3. Provide department leadership and direction in rethinking routine work to become more patient centered. Moves department thinking in direction of organizational vision.
• 3. Clinical Objectives
• 3.1. Maintain effective care coordination in a timely manner while monitoring the use of hospital resources, identifying and bringing issues to responsible parties and providing resolution where possible.
• 3.2. Understanding of Interqual criteria, levels of care, length of stay management, Value Based Purchasing, Bundled Payments, Preferred Provider Networks, and Right Care product.
• 3.3. Ensure staff complies with the departments discharge planning policy, including all Conditions of Participation.
• 3.4. Ensure CM collaborates with interdisciplinary team regarding safe handoffs to the next level of care.
• 3.5. Ensure that all policies and procedures are in place and updated to support daily operations in an ever changing environment.
• 3.6. Ensure compliance with delivery of Medicare Important Message upon discharge.
• 3.7. Manage Care Management program for at-risk, high cost and/or complex patients that may reduce gaps in care.
• 4. Financial
• 4.1. Evaluates opportunities to prevent readmissions, monitor LOS, and transitions to the next level of care when clinically appropriate.
• 4.2. Maintains a collaborative relationship with all department managers.
• 4.3. Ensure staff relays financial responsibility in all patient interactions.
• 4.4. Ensure clinical processes are in place and financial and quality outcomes are achieved.

EDUCATION

Minimum of Baccalaureate Degree in clinically related field. RN required. Master's Degree Preferred.

EXPERIENCE

Minimum five (5) years' experience in Care Management or related field. Supervisory and leadership experience desired.

LICENSURE

Current Connecticut State RN Nursing Licensure and/or eligibility for Connecticut State RN Licensure required. Case Management or other relevant certification desired.

SPECIAL SKILLS

Critical thinking, excellent communication skills, understanding of systems and ability to manage multiple priorities mandatory. Working knowledge and experience with IT systems. Knowledge of regulatory, insurance, health care systems, hospital management. Ability to utilize lean thinking and process improvement cycles. Ability to understand and use data in decision making useful. Ability to understand budgets and financial planning desired.

PHYSICAL DEMAND

Prolonged sitting and standing may be required. Must be able to move about the institution throughout the day.