Manager, Case Management

Job Purpose

The Case Management Manager is responsible for the day-to-day management of the Case Management department. This includes, but is not limited to supervision of staff, staff assignment / productivity, staff recruitment, retention, daily staffing, employee performance evaluation, performance improvement, and staff education.

The Case Management Manager serves as a resource / mentor for Case Managers, Social Workers and other medical and hospital staff, and participates in the development and implementation of new initiatives that support excellence in patient experience and drive efficiency and efficacy of the case management operations. The Case Management Manager reports to and assists the Directors of Case Management and Social Work.

Duties and Responsibilities

Clinical Leadership

• Develops, implements, and maintains professional standards.
• Serves as a clinical resource and lends guidance to staff in utilization management, discharge planning, and care coordination issues.
• Provides operational and clinical oversite to ensure that all day-to-day activity supports optimum patient throughput and excellent patient care.
• Demonstrates integral involvement in the quality improvement activities of the case management department.
• Works with the case managers, clinical nurse managers, physicians, and social work to facilitate Interdisciplinary Rounds to ensure compliance with the patient treatment plan.
• Facilitates patient flow and monitors length of stay for each patient.
• Collaborates with the Directors of Case Management and Social Work to maintain, review and update all policies in accordance with hospital, professional and regulatory standards.
• Creates and maintains an environment of care where patients, families, staff and others are treated with respect, dignity and in a professional manner, promoting an environment respectful of cultural diversity.
• Attends interdisciplinary rounds as necessary.
• Meets with Case Managers and Social Workers to review medically complex and long stay cases and refers to physician advisors as required.
• Regularly reviews avoidable day, excess day and denial data for follow-up and development of process improvement actions as necessary.
• Ensures UM deliverables are met such as timely admissions and continued stay reviews.

Administration

Communication and Reporting

Qualifications

Working Conditions

Occasional travel and flexibility to work outside of normal business hours as needed.

Disclaimer

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non‑merit based factors, or any other characteristic protected by federal, state or local law.

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