Manager of Case Management - Maryview Medical Center in Cornholme

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.

Job Summary

The Manager, Care Management is responsible for day-to-day oversight, coordinating, organizing and managing functions and resources for the Care Management Department. This role collaborates and coordinates with Care Management Leadership and colleagues to achieve standardization of assigned functions and responsibilities. This role combines the clinical and the financial components to achieve the best possible outcomes for the patients served and the organization.

Essential Functions

• Provides leadership and oversees day-to-day operations to Care Management Team.
• Works with Care Management leadership and colleagues to achieve standardized practices and processes related to Advance Care Planning, Length of Stay (LOS) management, readmission prevention, use of predictive readmission tool and application of appropriate interventions, denial prevention related to medical necessity through proactive progression of care and addressing barriers to care.
• Monitors success through qualitative and quantitative data and takes appropriate action to mitigate barriers and improve outcomes.
• Advocates and educates regarding right care, right time at the right place.
• Provides education to care management staff, physicians and nursing, other care teams members regarding effective progression of care, Level of Care (LOC), and safe and timely transition management.
• Supports national standards for care management scope of service: Education, Care Coordination, Compliance, Transition Management and Resource Utilization.
• Utilizes systems within the Care Management Department to support an effective and proactive care management process across the continuum.
• Collaborates with ambulatory and post-acute providers and staff to ensure seamless transitions of care.
• Partners with physician leader to optimize the Utilization Management Committee, providing actionable data related to utilization opportunities identified through qualitative data and quantitative data analytic platforms.
• Directs daily operations to achieve effective utilization of personnel resources consistent with patient and ministry needs.
• Assists in development of annual departmental goals and objectives, aligns with system Care Management goals and objectives.
• Participates in the development and management of the annual budget. Identifies and achieves cost reductions.
• Works collaboratively with staff and other key stakeholders to reduce cost.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Education

• Bachelor of Science Nursing or Social Work (required)
• Masters, Nursing, Social Work, or Healthcare Administration (preferred for BSMH, required for RSFH)

Experience

• 3 years of recent acute hospital care management experience (required)

Skills and Abilities

• Care management
• Discharge planning
• Patient Advocacy
• Flexible
• Care Planning
• Care Coordination
• Analyzing data or information
• Reimbursement methodologies
• Staffing workflow and bed allocation
• Clinical knowledge
• Tracking
• Working knowledge of local and state resources
• Knowledge of government and non-government payor practices, regulations, standards and reimbursement

Soft/Interpersonal Skills

• Leadership
• Mentorship
• Training Employees
• Knowledge Sharing
• Attention to detail
• Critical thinking
• Communication with family members
• Conflict resolution
• Proactive

As a Bon Secours Mercy Health associate, you are part of a Mission that matters. We support your well-being—personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What We Offer

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability.