Required Skills/Experience:
Two years experience in process improvement; minimum 5 years Case Management experience in an acute setting.
Experience in development and presentation of professional continuing education programs.
Knowledge of CMS regulations.
Preferred Skills/Experience:
Management/supervisory experience preferred.
Preferred Credentials:
Master's degree preferred.
Certification in Clinical Documentation Integrity preferred.
Unit Details:
Manages the daily operations and clinical functions of Case Management, Utilization Review, and Social Work, with a secondary focus on the Clinical Documentation team.
Manages case management and social services staff and workflows, including scheduling and performance evaluations.
Oversees discharge planning, utilization management, and care coordination/high-risk patient processes.
Rounds on patient units regularly to identify problem areas and facilitate discharge.
Develops and conducts continuing education and process improvement for Clinical Resource Management staff, including case managers and social workers.
Provides education on discharge planning and utilization review to case managers, social workers, physicians, nurses, and allied health professionals.
Tracks and trends Clinical Resource Management program compliance, creates dashboards to identify improvement opportunities, and implements process improvement activities.
Develops, mentors, and coaches continual improvement in collaborative practice among physicians, nurses, and the clinical resource team.
Analyzes and reviews program metrics using working knowledge of the systems used in the departments.
Stays current with regulatory changes in the case management field.
Pre-employment modules may be required for this role. Please upload any certifications or health documents you have to your profile to expedite your on-boarding process.
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