Thank you for considering a career at Mercy Health!
Scheduled Weekly Hours:
40
Work Shift:
Days (United States of America)
As a faith-based and patient-focused organization, exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. BSMH seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.
Manager, Care Management – Tiffin Hospital, Defiance and Willard!
The Manager, Care Management is responsible for day-to-day oversight, coordinating, organizing and managing functions and resources for the Care Management Department. This role collaborates and coordinates with Care Management Leadership and colleagues to achieve standardization of assigned functions and responsibilities. This role combines the clinical and the financial components to achieve the best possible outcomes for the patients served and the organization.
Essential Functions:
- Provides leadership and oversees day-to-day operations to Care Management Team. Works with Care Management leadership and colleagues to achieve standardized practices and processes related to Advance Care Planning, Length of Stay (LOS) management, readmission prevention, use of predictive readmission tool and application of appropriate interventions, denial prevention related to medical necessity through proactive progression of care and addressing barriers to (including tracking of avoidable days or delays), daily team rounding, care transitions, patient satisfaction related to care transitions. Monitors success through qualitative and quantitative data and takes appropriate action to mitigate barrier and improve outcomes.
- Advocates and educates regarding right care, right time at the right place. Provides education to care management staff, physicians and nursing, other care teams members regarding effective progression of care, Level of Care (LOC), and safe and timely transition management. Supports national standards for care management scope of service: Education, Care Coordination, Compliance, Transition Management and Resource Utilization.
- Utilizes systems within the Care Management Department to support an effective and proactive care management process across the continuum, working closely with and aligns with population health and community health efforts supporting a patient-centered care management model that spans the continuum. Collaborates with ambulatory and post-acute providers and staff to ensure seamless transitions of care.
- Partners with physician leader to optimize the Utilization Management Committee, providing actionable data related to utilization opportunities identified through qualitative data and quantitative data analytic platforms such as Quality Advisor and other facility or system resources.
- Directs daily operations to achieve effective utilization of personnel resources consistent with patient and ministry needs. Assist in development of annual departmental goals and objectives, aligns with system Care Management goals and objectives. Assists in development of strategic departmental plans and initiatives. Fosters integration and strong collaborative partnerships with nursing, quality, hospitalist, physician advisor, other physician leadership in supporting and engaging in clinical integration activities in order to optimize high quality, cost efficient care.
- Participates in the development and management of the annual budget. Identifies and achieves cost reductions. Works in concert with organization colleagues to achieve standardization of operations. Understands the financial impact of contracts and changing payment models from fee-for-service to value-based care. Works collaboratively with staff and other key stakeholders to reduce cost
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.
Education:
- Bachelor of Science Nursing or Social Work (required)
- Masters, Nursing, Social Work, or Healthcare Administration (preferred for BSMH, required for RSFH)
Licensure/Certification:
- BLS Basic Life Support – American Heart Association (required)
- RN License in state of practice or Licensed as a Social Worker in state of practice (required, SW license preferred in VA)
- Accredited Case Manager Certification (ACM) from American Case Management Association or Certified Case Manager (CCM) from Commission for Case Manager Certification or American Nurses Credentialing Center (ANCC) Nursing Case Management board certification (preferred)
Experience:
- 3 years of recent acute hospital care management experience (required)
Skills and Abilities:
Hard/Tech/Clinical Skills:
- Analyzing data or information
- Reimbursement methodologies
- Staffing workflow and bed allocation
- Working knowledge of local and state resources
- Knowledge of government and non-government payor practices, regulations, standards and reimbursement
Soft/Interpersonal Skills:
- Communication with family members
Mercy Health is an equal opportunity employer.
As a Mercy Health associate, you’re part of a Misson that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.
What we offer
• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support
Benefits may vary based on the market and employment status.
Department:
Case Mgmt - Tiffin Hospital
It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health– Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.
