Catholic Health Initiatives Manager - Care Management - Ambulatory Care in OMAHA, Nebraska

Manager - Care Management - Ambulatory Care

Description

Manager - Care Management - Ambulatory Care

JOB DESCRIPTION POSITION SUMMARY

Works collaboratively with physicians, staff and other health care professionals within his/her Division to coordinate the care and service of selected patient populations across the continuum. The role performs supervisory duties over care management staff and activities. The role works collaboratively with patient, family, physician and other members of the health care team to achieve the highest quality clinical outcomes with the most cost effective use of available resources. The role provides training and technical support, monitoring caseloads for accuracy in the application of program rules and regulations, and identifying areas for process improvement in order to support the care management team. The role serves as a liaison to internal and external stakeholders in order to maintain and improve collaborative relationships, exchange information, and resolve problem areas; and recommends process improvements. The Care Management Supervisor is an integral member of the health care team as well as the Divisional Care Management team. In addition the position collaborates with the Divisional Care Management team on system-wide quality improvement/performance improvement initiatives.

Uses and discloses patient protected health information: 1) Only as it applies to job functions, 2) in amounts minimally necessary for intended purpose, and 3) in a confidential manner.

LEADERSHIP ACCOUNTABILITIES

  • Has the authority to interview, hire, orient, terminate, promote, train and conduct performance evaluations.

  • Assigns day-to-day work activities; directs the functional and technical job performance of team members.

  • Allocates and directs staffing needs to meet patient, unit/department and organizational needs and collaborates with others to ensure overall staffing needs are met.

  • Manages performance including: setting goals, clarifying job expectations, monitoring performance progress, providing feedback, recognizing performance, developing skills and addressing performance issues related to work and our Commitments using corrective action.

ESSENTIAL JOB RESPONSIBILITIES

  • Understands and self-manages to support facility/CIN-level success goals, including improvements in quality, cost of care and member experience for the facility/CIN’s population.

  • Identifies opportunities for improvement (at individual, clinic and facility/CIN levels) and actively works with healthcare and facility/CIN team to correct or improve results.

  • Responsible for the financial budget of this division

  • Evaluates current staffing utilizing approved staffing ratios and submits requests for additional staff as it relates to the staffing model

  • Stays current, audits, educates and trains on regulatory and reimbursement issues

  • Reviews, develops, or modifies work plans, methods, and procedures, determines work priorities, and develops work schedules to provide adequate staff coverage

  • Supervises and evaluates the work of employees who interview applicants to obtain information and determine initial and on-going care management needs

  • Resolves problems and mediates conflicts encountered during daily operations, determines appropriate solutions, and promotes teamwork

  • Provides work instruction and assists employees with difficult and/or unusual assignments and encourages innovation

Qualifications

MINIMUM QUALIFICATIONS

Required Education and Licensure

  • Bachelor’s Degree and minimum of 3 years leadership experience OR minimum of 5 years leadership experience in the discipline OR Master’s Degree and no experience

  • Current unrestricted license, as a registered nurse in the state you live or social worker license in state(s) of practice.

  • Basic Life Support (BLS) for the Healthcare Provider certified or obtained within 30 days.

  • For Iowa residents and employees licensed out of Iowa it is required to complete Mandatory Reporter abuse training specific to population served within six (6) months of hire.

Required Minimum Experience

  • Minimum 3 years clinical experience as Registered Nurse (RN) or Social Worker

Bona Fide Occupational Qualifications (BFOQs)

  • List as applicable or N/A if no BFOQs exist

Preferred Qualifications

  • Masters of Science in Nursing preferred and/or Masters of Social Work (MSW) preferred.

  • Minimum 5 years clinical experience as Registered Nurse (RN) or Social Worker

  • Minimum 5 years managed care or equivalent care management experience preferred.

  • Case management certification (CCM or ACM) preferred.

  • Knowledge with Indicia (formally Milliman Care Guidelines) authorization criteria preferred.

Minimum Knowledge, Skills, and Abilities

  • Demonstrated experience in case management, discharge planning, and transfer coordination

  • Knowledge of information technology to evaluate care effectiveness (care process, outcomes and cost)

  • Ability to work autonomously within matrix environment without direct supervision or support.

  • Ability to work autonomously within matrix environment without direct supervision or support.

  • Demonstrated ability to set and maintain multiple priorities in an environment with shifting priorities, while providing accurate deliverables in a timely fashion

  • Must be self-motivated, and able to take ownership of projects/assignments

  • Must be a team player with excellent follow-up and customer service skills

  • Strong interpersonal, verbal, and writing skills

  • Interpersonal skills in dealing with guests and team members

Job Director/Manager/Supervisor

Primary Location NEBRASKA-OMAHA-SERVICE CENTER-SOUTH BLDG

Daily Schedule Days

Scheduled Hours per 2-week Pay Period 80

Weekends Required Occasional

Req ID: 2018-R0168735

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.