Manager, Care Management

📁
Director/Manager/Supervisor
📅
2019-R0238114 Requisition #
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Position Type: Regular
Scheduled Hours per 2 week Pay Period: 80
Primary Location: NE > OMAHA > CUMC-BERGAN MERCY

Your time at work should be fulfilling. Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities. Imagine your career at Catholic Health Initiatives!

 

 

Works collaboratively with physicians, staff and other health care professionals within the 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 Manager of Care Management is an integral member of the health care team. In addition the position collaborates with the Divisional Care Management team on system-wide quality improvement/performance improvement initiatives.

Essential Key Job Responsibilities

 

 

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, and department needs, and collaborates with others to ensure overall staffing needs are met.

 

Manage performance including: Setting goals, clarifying job expectations, monitoring performance progress, providing feedback and recognition, developing skills and addressing performance issues related to our work and our Commitments using corrective action.


Understands and self-manages to support organization success goals, including improvements in quality, cost of care and member experience for the population served.


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


Responsible for the financial budget of the department.  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.

 

     Leads and participates in activities to ensure successful development, implementation and monitoring of all strategic initiatives for Care Management.

     Assists with the analysis of denied days, denial report preparation and trending of denial data and physician performance.

     Serves as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation.

 Minimum Qualifications:

 

Bachelor’s Degree required.



 

Registered Nurse Licensure or Licensed as Social Worker Required.


About Us


Chances are, you’re here because you’re looking for a career offering greater opportunity, challenge and fulfillment. We’re confident you’ll find all three at CHI. As one of the nation’s largest nonprofit health systems, we offer a wealth of careers across more than 101 hospitals in 18 states. Our faith-based health system welcomes you to share in our mission of building healthier communities, whether as a surgeon in the operating room or an administrator in a conference room. When you work in a supportive environment with like-minded professionals, wonderful things happen. Learn More

Equal Opportunity Employment


Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic

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