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Mgr, Care Management

Company: Beaumont Hospitals
Location: Royal Oak
Posted on: June 8, 2021

Job Description:

GENERAL SUMMARY:

Under the direction of the Care Management Director, the Manager, Care Management is responsible for coordination of all activities in one or more of the key functions in the Care Management Department including Inpatient Care Management, EC Care management, Utilization Management (may also include Social Work). Works collaboratively with multiple disciplines to expedite care coordination functions in assigned areas. Responsibilities include all staff in assigned areas. Reports to the Care Management Director.

ESSENTIAL DUTIES:

  • Guides staff and works to create and maintain efficient and effective processes to manage the operations of the designated areas within the department.
  • Participates in, oversees, and assumes responsibility for the development of goals within assigned areas of responsibilities which are congruent with and support Beaumont Health strategic goals.
  • Works collaboratively with Revenue Cycle and Managed Care Contracting to communicate and understand payer requirements, to optimize payment coordination, and to develop processes and systems to promote timely reimbursement for services rendered to patients.
  • Interviews, hires, disciplines, evaluates, and manages all direct reports. Conducts staff meetings and other forms of communications with staff to maintain standards and consistency within the department.
  • Provides input into the department policies, procedures, objectives, and budget related to area of responsibility that promote organizational and departmental objectives.
  • Problem solves and intervenes with physician, nursing staff, and other ancillary staff to facilitate patient care and resolves barriers to care management functions. Collaborates and coaches staff regarding complex cases, extended length of stay, and payer concerns to provide appropriate direction and follow up.
  • Special projects/presentations as indicated.
  • Representative/liaison for department/hospital within the community.

KEY LEADERSHIP COMPETENCIES:

  • Builds Trust
  • Creates and Communicates Clarity
  • Works Collaboratively and Fosters Teamwork
  • Builds a Cohesive Team
  • Utilizes Strategic Judgment
  • Cultivates a Service-Oriented Culture
  • Creates and Communicates Vision and Strategy
  • Leads Change and Innovation

STANDARD QUALIFICATIONS

  • Education / Training:
  • Bachelor of Science in Nursing required. Master of Nursing or master's in health care field preferred.
  • Work Experience:
  • 5 years of nursing experience including 2 years of progressive experience in utilization review, discharge planning, systems management, and third-party payer requirements required.
  • Certification, Licensure, Registration:

  • Active and valid Michigan Registered Nurse Licensure
  • Certification in Case Management preferred.
  • Other Qualifications:
  • Excellent interpersonal relations, communication skills and decision-making skills.

Keywords: Beaumont Hospitals, Royal Oak , Mgr, Care Management, Other , Royal Oak, Michigan

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