Manager, Case Management

Allegheny Health Network - Pittsburgh, PA (30+ days ago)3.6


Description

GENERAL OVERVIEW:
Manages, supervises, and coordinates the daily operations of a specific patient care team, providing clinical and administrative leadership and expertise. Contributes to the strategic planning process and attainment of goals of the department, the organization and network

ESSENTIAL RESPONSIBILITIES:
LEADERSHIP:
Responsible for implementation of mission, vision, philosophy, core values, evidence based practice (EBP), and standards of the organization, and nursing service within their defined areas of responsibility.
Demonstrates and role models professional behavior with all staff interactions.
Serves as change agent and role model for change to assist staff in accepting and embracing the necessary change.
Collaborates with physician advisors and partners to share performance metrics and patient care progression goals.
Leads organization initiatives for daily care progression huddles, prolonged stay forums, and complex care management processes.
Conducts monthly unit conferences with minutes which include discussions of both unit and organizational activities and goals.
Completes annual performance appraisals on associates which includes peer feedback process, plan for professional development and employee self-appraisal.
Attends greater than 50% of leadership meetings.
Promotes departmental shared governance process to include ongoing support through consultation and assistance in eliminating barriers.
Promotes ongoing development of staff.
Promotes collaborative practice within unit-based teams of social workers and nurse care managers.
Promotes and encourages specialty certification.

QUALITY AND PATIENT SAFETY:
Identifies, plans, and implements activities in specified clinical departments to promote interdisciplinary collaboration on behalf of the patient and their family to ensure safe and efficient care progression, effective and appropriate transition plans, and excellent clinical and patient experiences.
Monitors departmental performance in appropriate EBPs, quality and patient safety goals, meeting assigned goals.
Develops action plan for any goal not met which includes timeline.
Participates in 85% of monthly Joint Commission mock tracers.
Develops a yearly unit based quality plan with unit based clinical practice and PI council based on identified unit needs.
Assures departmental participation and compliance with Six Sigma (LEAN) projects goals related to through put and other quality improvement initiatives.

CUSTOMER SATISFACTION:
Assures that department works collaboratively with patients, families, physicians, and members of the interdisciplinary clinical teams to meet established organizational goals for patient experience.
Reviews nursing department Press Ganey report, making the connection to the care management team contributions and providing feedback to staff at monthly unit conference.
Investigates and provides feedback for identified patient or departmental concerns.
Rounding for Purpose weekly to assess patient and family needs.
Develops departmental plan to address any improvement needs.
Meet or show consistent progress toward meeting established patient experience goal(s).

FINANCE:
Demonstrates fiscal stewardship through effective and efficient use of staff, facilities, equipment, and other resources while maintaining patient care standards.
Maintains both FTE and Goods/Services within established budget, completes variance reports according to established guidelines.
Provides consistent communication and feedback related to length of stay, resource utilization, and prevalence of avoidable days.
Coaches care management/social work teams in use of avoidable day tracking metrics, key factors in level of care determination, and variation in payor requirements.
Utilizes established tools to monitor monthly budget performance, conducting drill down to explain variances as needed.
Reports budget performance at monthly unit conferences.

PROFESSIONAL GROWTH AND DEVELOPMENT:
Fosters the development of staff through coaching, mentoring, and creating an environment which encourages learning and use of research.
Assures appropriate orientation, education, credentialing, and professional development for personnel.
Encourages and facilitates staff membership on evidenced-based practice/research committee, and clinical practice councils.
Encourage and facilitate attendance at nursing grand rounds according to educational needs assessment of unit/department or network.
Foster peer review participation with staff an d participate in peer review with other managers..
Set professional developmental goals with staff member at yearly evaluation.
Identifies one area for self-improvement annually and develops a plan to improve.

QUALIFICATIONS:
Minimum

MSN (Education and experience will be considered in lieu of degree)
Current PA RN licensure
Preferred

Professional National certification