Manager, Care Management

2019-R0241050 Requisition #
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Job Summary / Job Purpose


Provides leadership to Care Management RNs, Social Workers, Utilization Management RNs and support staff to accomplish the operational functions and performance goals of the department, which include efficient patient throughput, safe and effective care transitions, and compliance with payer and regulatory requirements.


Essential Functions

  1. Operational Efficiency
    1. Schedules team members so department is adequately staffed and patient needs are met.
    2. Monitors and adjust staffing to achieve productivity targets and accomplish essential work functions of department.
    3. Adjusts staff workloads to meet demand and ensure work is accomplished in a timely manner.
    4. Monitors expenses against budget and plans proactively for departmental costs and charges. Works with director to develop department budgets.
    5. Effectively uses managerial tools and software (e.g. Kronos, Workday, Premier, Lawson, Webnow).
  1. Staff Performance
    1. Interviews and hires staff that are competent and will assist with meeting department goals.
    2. Trains and develops staff to ensure their work is of high quality and aligned with departmental, regulatory and payer requirements.
    3. Evaluates staff performance fairly and provides meaningful feedback on progress towards performance goals..
    4. Observes and coaches staff as they perform their work to give real-time feedback.
    5. Engages staff in department, hospital, and KentuckyOne Health goals and results. Works with staff members to develop and achieve their own performance goals.
  1. Resource/Role Model
    1. Provides expertise in problem-solving for difficult patient issues.
    2. Knowledgeable in all aspects of Utilization Management and Care Management, including CMS regulatory requirements, and ensures compliance.
    3. Demonstrates excellent communication and negotiation skills.
    4. Role models service excellence, safety behaviors and KentuckyOne Health values.
  1. Achieves Results
    1. Uses data to monitor and communicate department performance metrics.
    2. Identifies areas for improvement and participates/leads performance improvement activities.
    3. Possesses strong organizational skills. Able to prioritize and delegate to manage a challenging workload. Holds staff accountable to accomplish assigned work.
    4. Aligns with organizational goals and works collaboratively with direct reports, peers and hospital leadership to achieve results.
    5. Partners with payers and Revenue Cycle to improve financial performance and ensure payer processes and requirements are met.
    6. Works collaboratively with patients, families, physicians and community partners for care transitions.

Job Requirements / Qualifications


Education / Accreditation / Licensure (required & preferred):

    • Current unrestricted license as a registered nurse or social worker in state(s) of practice is required.
    • Registered Nurse: Bachelor of Science in Nursing required; Masters of Science in Nursing preferred.
    • Social Worker: MSW required.

Experience (required and preferred):

    • Minimum 5 years clinical experience as Registered Nurse (RN) or Social Worker required.
    • Minimum 2 years managed care or equivalent care management experience required.
    • Minimum 1 year leadership experience preferred.




About Us

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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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