Manager Care Management - Registered Nurse

Overview

This position is onsite in Lebanon NH

 

Principal manager of case management, to include analysis of cost, length of stay, utilization, and clinical quality. Monitors guidelines for working with insurers to determine cost effectiveness of clinical plans.

Responsibilities

Develops and updates departmental policies and procedures around clinical care as well as psychological, social and environmental issues.

Assists in analyzing statistical/workload data. Provide to staff the data needed for them to make informed decisions to achieve equitable workload distribution.

Participates in departmental leadership meetings and on-going evaluation of the quality and scope of Case Management services. Serves as a conduit for communicating strategic and operational information between staff and administration. Keeps the department director informed of significant operational trends, system barriers, and/or developments including all areas of practice, including clinical, psychological, social and environmental.

Provides consultation to staff on cases involving difficult practice issues.

Provides clinical services to patients and families.

Ensures appropriate staffing levels and on-call coverage.

Participates in the identification and development of measures of success for the Case Management program. Participates in the evaluation of clinical and financial data/outcomes including patient satisfaction, health and functional status, resource utilization and practice variation. Identifies and recommends opportunities for improvement in the process of care.

Participates in unit/service based activities as indicated to promote the development of established matrix relationships.

Participates in the clinical development of disease management strategies.

Participates in the screening and selection of professional staff. Coordinates orientation of new staff. Organizes and provides educational programs to Case Management staff, other departments and disciplines and medical and other allied health professional students. Facilitates completion of annual performance appraisals for assigned staff and takes action to address performance deficits. Ensures peer to peer coaching and feedback.

Performs other duties as required or assigned.

Qualifications

• Master’s degree (or matriculated into a master’s degree program)
• BSN required.
• 3 years of case management experience required.
• Strong leadership, communication, and computer skills desired.
• CCM, ACM or CMAC preferred.
• 5 years of supervisory experience preferred.

Required Licensure/Certifications

• Licensed Registered Nurse with NH eligibility
• Basic Life Support (BLS) Certificate required.