• Manager Case Management

    Department Case Management
    Posted Date 5 days ago(9/12/2019 2:08 PM)
    Job ID
    2019-6521
    # of Openings
    1
    Job Locations
    US-AZ-Sacaton
    Category
    Management
    Job Type
    Full Time
    Shift
    Days
    Recruiter : Email Address
    asuor@GRHC.ORG
  • Overview

    Supervises, coordinates and manages the care management function to facilitate achievement of quality and cost effective patient outcomes by working collaboratively with interdisciplinary staff, internal and external to the organization in accordance with established treatment plan. Performs discharge planning, case management and utilization review to ensure timely and appropriate transition of patient based on care/service needs.  Carries a case load in one or more services lines

    Responsibilities

    • Directs process of establishing a clear strategic direction for the Care Management Department to ensure mission, vision and values are upheld and strategy is consistent with the annual organizational plan of the hospital.
    • Directs, manages and supervises daily administrative operations of the department to ensure highest quality developmentally appropriate patient care consistent with established professional, regulatory and governmental standards
    • Develops clinical and financial outcome measures, related tracking and monitoring systems and a mechanism to integrate efforts into organization-wide Quality Improvement systems
    • Develops and implements policies and procedures to ensure compliance with all federal, state, licensing and regulatory requirements and practices
    • Develops, manages and supervises purchasing and management of equipment and instrumentation to ensure availability of proper and functioning equipment for safe delivery of care
    • Works collaboratively with a variety of stakeholders to recommend, develop and implement methods/procedures for coordination of services with related patient care activities.
    • Prepares and distributes monthly status and statistical reports of activities
    • Plans, develops and manages department strategies and operational budgets to ensure provision of services consistent with desired objectives delivered responsibly
    • Serves as primary contact/clinical liaison between referral hospitals, treatment facilities and patients/patient’s families to ensure delivery of effective and appropriate treatment in accordance with established plan of care
    • Facilitates, schedules and/or participates in a variety of patient care coordination activities to ensure patient and/or family personal and health care needs are met in a timely manner; proactively identifies alternative resources as needed
    • Collaborates with patient, family members and other involved parties to ensure coordination of care coverage through private and governmental health care plans
    • Monitors eligibility status with AHCCCS; initiates action to re-instate eligibility to ensure continuity of treatment
    • As Oncology Coordinator, acts as primary patient advocate to ensure coordination of services; discusses drugs/treatment plan, outcomes and effects; locates and acquires necessary durable medical equipment and/or wigs; facilitates hospice arrangements including transportation
    • As Transplant Coordinator, acts as primary patient advocate/contact to ensure patient complies with program protocols; performs follow up on behalf of patient regarding transplant list and provides support and information as needed
    • Manages and oversees care coordination of high risk patient case load to ensure delivery of all covered services identified for continuity of care across all levels of care and involved providers;
    • Develops and implements transition, discharge and aftercare plans of assigned patients
    • Performs chart review, develops treatment/service plan to meet determined care needs; revises care plan as appropriate based on acuity level
    • Receives and responds to all patient complaints; researches issues for corrective action as appropriate based on findings; escalates physician/provider issues to appropriate parties and identifies alternative solutions
    • Participates in departmental orientation, on the job training and quality assurance programs/initiatives
    • Participates in a variety of department and hospital educational programs to maintain current skill and competency levels; identifies and discusses performance or training needs with Supervisor

    Qualifications

    • Bachelor’s degree (Master’s Degree preferred) in Nursing or closely related field; equivalent combination of education and experience
    • Current State of Arizona Register Nurse license; CPR certificate within 30 days of hire
    • Must have at least 2 years previous discharge planning, utilization review and/or case management experience; Native American population preferred

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