HCA, Hospital Corporation of America Manager Case Management in Englewood, Colorado
*Position Summary: *This position supports the mission of Swedish Medical Center optimizing the quality of life of all those served by expanding the traditional focus on medical needs to the needs of the whole person. The Case Management Manager is responsible and accountable for overseeing the coordination of services through an interdisciplinary process that provides a clinical, financial and psychosocial approach through the continuum of care. Balances individually identified patient and family needs with the efficacious and cost effective utilization of resources. Through concurrent clinical case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, clinical resource consumption, progressive care management, as well as appropriate level of care. Discharge planning will begin at the time of (or prior to) admission and reassessed throughout the course of hospitalization. Quality and Risk Management issues and education needs will also be monitored for and reported per hospital policy. When need arises, will perform other duties as assigned by the Case Management Direct and cover for the director as needed. This role is intended to mentor the individual for a future Director of Case Management position. Responsible for supervising day-to-day operations, including the staff schedule, assignments and caseloads to ensure appropriate hospital-wide coverage. Provides expertise and staff support for problem–solving complex cases and issues . Collaborates with Director and participates in staff evaluation and performance activities including monitoring, coaching, counseling, educating and developing action plans as needed. Represents CM and attends meetings for assigned committees, workgroups and teams. Develops and supervises new staff orientation plans and the department’s annual education plan, including staff core competencies.
Current Colorado Registered Nurse License or LCSW required.
BLS certification required.
UM/CM certification preferred.
Graduate of an accredited school of nursing or social work.
Bachelor’s of Science in Nursing and/or Master’s level degree preferred for RN & MSW required for social work.
Five or more years clinical experience required, hospital setting preferred.
Three to five years UM/CM experience required.
One to three years charge/lead/supervisory/management experience required, in UM/CM department role preferred. Able to demonstrate leadership and management skills.
Knowledge of all applicable federal and state regulations as well as accreditation standards. Demonstrates a working knowledge of UM, CM and Social Work in the acute care setting and with insurance payers, managed care and government healthcare plans. Working knowledge of UM review processes, payment/reimbursement and appeal procedures and regulatory requirements. Must have the ability to monitor, compile, report and analyze data/statistics. Requires excellent human relations, interpersonal and oral/written communication skills. Requires good knowledge and skills with Microsoft Office and other computer information systems and applications.
Routine CM Department hours of operation are 8:00 am-4:30 pm, 7 days/week including holidays.
CM Supervisor is responsible for assisting CM Director with some ‘24/7’ coverage, including filling in for Director’s time off.
Title: Manager Case Management
Location: Colorado-Englewood-Swedish Medical Center
Requisition ID: 03167-55579