Supervisor, Care Management

Description

Wage Range: $95,888 - $153,379 per year

Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.

Job Summary

Working under department management, specializes in assessing hospital admissions for status per defined criteria and reviews for appropriate utilization of resources. Ensures continuity and coordination of care for patients before, during and after hospitalization, and ensures that payer conditions are met.

Primary Duties:

Under the direction of the department Director/Manager of Care Management, supervises the day-to-day activities of the Care Management RNs.

Coordinates the staff schedules including vacation/holiday requests and weekend rotations.

Coordinates daily assignments

Functions as a resource to staff for clinical problem solving.

Provides employee feedback as needed and performs probationary and annual performance appraisals.

Participates in policy and guideline updates.

Facilitates orientation of new employees.

Follows and reinforces Medicare guidelines to ensure compliance with appropriate admission orders (i.e. Observation, Extended Recovery, Inpatient, Outpatient etc.)

Communicates regularly with department Director/Manager to provide updates on status of projects or issues and other necessary feedback.

Continually evaluates patient flow and provides intervention to facilitate patient care in an optimal timeline.

Oversees utilization review process including education, support, and training of team members to ensure standardization and support on difficult cases.

Anticipates problems and obstacles in care coordination and applies appropriate problem-solving skills to prevent or reduce delay in patient care/discharge.

Provides leadership and continuity of care guidance and support for patients with chronic diseases and/or complex disease states as they receive care throughout the care continuum.

Uses knowledge of illness, diagnoses, and treatments in comprehensive, holistic assessments of patients.

In conjunction with the interdisciplinary team supervises progress and recommends appropriate clinical interventions to nursing staff and attending physicians, supporting compliance with Center for Medicare and Medicaid Services guidelines.

In conjunction with the interdisciplinary team ensures that patients and families have access to resources for post-hospital care needs.

Monitors the patients' medical progress, identifies and addresses patient needs/gaps in service as they move through the system, and obtains authorization for discharge planning.

Takes action to correct variances in length of stay and address them in care progression rounds; follows up with physicians and payors as needed.

Oversees utilization reviews, meeting all time requirements and addresses the discharge appeal process in collaboration with the Director/Manager and/or Social Worker/RN Case Manager.

Performs other duties as assigned

License, Certification, Education or Experience:

REQUIRED for the position:

• Bachelor of Science degree in Nursing
• 2 years acute care or case management experience
• Current State of Washington RN license
• Current Healthcare Provider BLS - American Heart Association by start date
• Knowledge of the healthcare financial environment, reimbursement, and levels of care.
• Maturity and interpersonal skills necessary to lead and coordinate an interdisciplinary team and deal effectively with patients and families from a variety of backgrounds and with varied emotional and medical needs.
• Verbal and written language skills; visual and aural skills to communicate, ensure and deliver safe patient care and to provide a legal record of this care.

DESIRED for the position:

• Master's degree in nursing
• 5 years of experience as an RN
• Previous leadership experience
• Case Management Certification from ACMA

Benefit Information:

Choices that care for you and your family

At EvergreenHealth, we appreciate our employees' commitment and contribution to our success. We are proud to offer a suite of quality benefits and resources that are comprehensive, flexible, and competitive to help our staff, and their loved ones maintain and improve health and financial well-being.

• Medical, vision and dental insurance
• On-demand virtual health care
• Health Savings Account
• Flexible Spending Account
• Life and disability insurance
• Retirement plans 457(b) and 401(a) with employer contribution)
• Tuition assistance for undergraduate and graduate degrees
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidays
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Cafeteria & Gift Shop Discount

View a summary of our total rewards available to you as an EvergreenHealth team member by clicking on the link below.

EvergreenHealth Benefits Guide