Manager of Case Management

Job Summary: The Manager of Case Management assists the Director with the overall development of the case management program and implements at the local level. This includes oversight of all case management staff, development and implementation of case management policies and procedures, and coordination of care with other healthcare providers and community resources. The Manager of Case Management also plays a key role in ensuring that the case management program is meeting its goals and objectives, and that it is compliant with all applicable regulations. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Essential Functions:

Assists in the development and implementation of case management program, in alignment with its overall strategic goals and objectives.
With the director oversee a staff of case managers, including hiring, training, performance management, and disciplinary action. Ensuring optimal provision of services through sound personnel management.
Assists Director with the development and implementation of case management policies and procedures, ensuring that they are aligned with best practices and applicable regulations.
Coordinate care with other healthcare providers and community resources to ensure that patients receive seamless and comprehensive care.
Provides comprehensive reporting to the Director and other stakeholders to include KPI's, avoidable delays, LOS and other metrics as determined routinely.
Monitor and evaluate the effectiveness of the case management program and adjust as needed.
Ensure that the case management program is compliant with all applicable regulations.
Maintain department performance improvement and quality plans.
Represent the case management program to the organization's leadership team and to external stakeholders.
Maintain current competencies and updated knowledge in the specific area of practice.
With the director effectively manage financial resources within the area(s) of responsibility, including labor management, productivity, supplies, and other resources.
Collaborate with UM physician chair to develop and participate in scheduled UM Committees
Uses clear, concise, professional communication with coworkers, patients, all customers internal and external.
Uses AIDET in interactions with patients and family members.
Acts with a sense of urgency when performing tasks.
Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
Reports on any equipment and or environmental issues for repair.
Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.
Speaks up to stop the line and escalates potential safety events if necessary.
Completes and attends monthly training assigned.
Other duties as assigned.

Behavioral Standards:

Demonstrate behaviors commensurate with the vision, mission, values, and behavioral standards of the organization.
Serve as a role model for the mission, vision, and values of the organization and fulfill other job duties as requested within the scope of practice.
Serve as a role model and mentor for staff and peers.
Treats everyone as their customer; utilizes scripting and other tools to ensure consistency in customer service; Expresses recognition and shows appreciation to others; fully utilizes AIDET principles; responds quickly to handle requests, complaints, and questions; displays a positive attitude.
Demonstrates the highest level of professionalism, passion and care when interacting with patients, families, physicians, and hospital staff members.
Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential, embracing ingenuity to service our customers.

Communication/Knowledge:

Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer's and co-worker's time; establishes and maintains effective relationships with customers and co-workers.

Collaboration/Teamwork:

Attends staff meetings; follows HIPAA guidelines; follows patient rights policy; complies with the compliance program; demonstrates knowledge of role in a disaster; demonstrates knowledge of fire and fire drill procedures; working knowledge of hospital emergency codes; always utilizes standard precautions in the clinical setting; safely manages the environment of care by demonstrating a working knowledge of the requirements of the: Life Safety program, Utilities Management program, Hazardous Materials program, Emergency Preparedness program, Safety Management program, Medical Equipment Management program, Security Management program.

Qualifications/Experience:

Minimum of five (5) years' experience in Clinical Nursing required.
Minimum of five (5) years' experience in case management, preferably in a hospital setting.
Minimum of three (3) years' experience in a supervisory capacity or higher required.
Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, strong organizational skills, ability to follow verbal instructions, and PC (computer) skills.
A capacity to learn, synthesize, make critical judgments, work independently, place patients and families first, and collaborate with the team members who are recognized leaders within healthcare.

Education
Preferred
Bachelor of Science in Nursing or better
Licenses & Certifications
Required
RN Registered Nurse
BLS Basic Life Supp Cert
Preferred
ACM Accredited Case Mgr
CCM Certified Case Mgr
MAB Tier II - New Hire