Manager - Clinical Resource Management
Posted on Jan 14, 2019 by Covenant HealthCare
This position oversees the CRM Coordinators, a staff of Case Managers, Utilization Review Nurses, Social Workers, Clinical Documentation Improvement Specialists and Case Management Technicians (assistants) who are all responsible for patient care coordination and delivery of post-acute services. Provides input to the Director of Case Management regarding daily strategic decisions that affect the functional areas of the department. May give input, from time-to-time, into developing the annual budget and staff allocation. Must be capable of resolving escalated issues arising from daily department operations and coordination with other departments. Assists with developing and implementing case management programs, including utilization review, discharge planning, daily scheduling of all staff. Evaluates and assesses patient care data to ensure that care is provided in accordance with CMS Conditions of Participation and clinical guidelines by ensuring staff are using appropriate and Covenant HealthCare-endorsed tools that meet organizational standards. Contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while ensuring quality care given by all case management staff.
Responsible to provide leadership and direction in the daily operational activities of Social Work, Case Management, and UR functions by assuring that activities are appropriately assigned, resources are available, and requirements of external entities such as regulatory and third-party payers are met. Responsible for completing job evaluations, input into hiring decisions, providing input for budgeting and meeting productivity goals. Accountable for strategic planning, implementation, evaluation, and revision of systems that support the Case Management Department and organizational goals. Maintains 24-hour accountability for his/her area functions.
Responsibilities: • Ensures
that post-discharge follow up care is coordinated as appropriate with post-discharge care management team.
• Ensures that the department objectives and metrics are achieved timely and on-target according to identified goals.
• Communicates issues and concerns affecting the department's capacity to achieve results with the CRM Coordinators proactively and assists with crafting solutions that will positively impact identified goals.
• Assigns tasks according to priority and supports CRM Coordinators in carrying out activities to reach identified goals.
• Ensures that department needs are identified, analyzed and responded to in a timely manner.
• Carries out regular reviews of CRM Coordinators and provides support and supervision of all CRM Case Management staff when needed.
• Considers all factors that will impact the CRM Case Management Department design, implementation and reporting
EDUCATION/EXPERIENCE: • BSN or MSW preferred.
Will consider Bachelor's Degree in a Health Care related field .
• 3 -5 years of Case Management experience in an acute care setting
• Supervisory/Management experience required.
Minimum of five (5) years' experience in a patient care acute setting
• Experience with continuous performance improvement preferred.
• Working knowledge of navigating patients through procedures and across the continuum of care, knowledge of resources for patients in coordinating transitions between the hospital, post-acute services, and all other case manager duties.
• Maintains professional development through seminars, workshops, in-service activities and current professional literature
• ACMA certification preferred (must be obtained with 12 months of hire)
KNOWLEDGE/SKILLS/ABILITIES: • Ability to communicate effectively,both written and verbal communication, with persons of various cultural and educational backgrounds.
• Demonstrates knowledge
of case management including utilization review, social work assessments and clinical documentation improvement.
• Excellent organizational skills
to effectively coordinate all aspects of patient care.
• Ability to be an active, participatory member the
be required to participate
after hours and weekends
(verbal and written) of the English language. WORKING CONDITIONS/PHYSICAL DEMANDS: • Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.
• Frequent walking. sitting. talking and hearing.
• Occasional lifting 0-50 lbs.
• Occasional standing, carrying, pushing, pulling, climbing and stooping.
• Occasional reaching, handling, and fingering. Occasional near, midrange and far vision.
•Occasional color and field of vision. NOTICE REGARDING LATEX SENSITIVITY IN APPLICANTS FOR EMPLOYMENT.
It has been determined that Covenant HealthCare cannot provide a latex safe or latex free work environment at any of its facilities.
Unfortunately, that means that any individual, including an applicant or an employee, is likely to be exposed to latex while on Covenant's premises.
Therefore, latex tolerance is considered to be an essential function for any position with Covenant Category: Healthcare , Keywords: Clinical Services Manager