Regional Manager Case Management

Req#: R23795
Category(s): Nursing, Care and Case Managers
Full Time / Part Time: Full-Time
Shift:

The Regional Manager Case Management is a Registered Nurse and Case Management expert responsible for the planning and oversight of daily operations for all community hospitals, as well as oversight of the development of the respective Case Management teams. Working with the Supervisor(s) of CM at each community hospital, responsibilities include partnership with physician hospital leader(s) and other members of the care teams to facilitate effective coordination of clinical care and utilization management. The Regional Manager Case Management will oversee initial and continued stay level of care reviews using approved criteria, discharge coordination to achieve quality care and best financial outcomes, and general oversight of length of stay at each community hospital. Working with oversight from the Sr Director of Patient Care Services, the Regional Manager Case Management performs leadership duties including but not limited to: Human Resource management, coordination of new staff orientation with Regional CM Educator, competency monitoring and development, daily operations of all staff, policy development, performance evaluation and future developmental planning for each hospital as directed.

 

Serves as a knowledgeable clinical and case management expert: Assists community hospital case management supervisors with recruitment and hire of new staff, operational support to existing staff, and oversight of Hospital Case Management functions. Demonstrates exceptional communication and collaboration within and across departments. Develops relationships with key constituents at each hospital to facilitate teamwork and successful collaboration to execute results.

 

Responsible for direct oversight of day-to-day operations at the community hospital in which they currently reside, as well as oversight of all other community hospitals with case management supervisors in place.  Time will be balanced between the oversight of daily operations and as well as dedicated regional administrative work. Travel to all community hospitals is expected at times.

 

Works with the Regional Case Management Educator to update, develop and maintain the yearly programmatic competency requirements. Ensures staff compliance with annual competency requirements.

 

Recruits and hires staff in partnership with Case Management Supervisors. Provides direct observation and assessment of performance as indicated. Provides timely feedback to improve staff performance to develop individuals/team. Conducts annual performance reviews for direct staff and Community Hospital Supervisors.

 

Works collaboratively within and across teams to assess and manage clinical, utilization and financial outcome data evaluating innovative solutions to drive results. Assists in creating case management performance dashboard to report results; with a strong focus on Teletracking and XSolis.  

 

Assists the Sr Director to lead change and execute strategic plan to implement contemporary case management model. Drives and supports development of case management program and integration and partnership with other clinical services.

 

Assists the Supervisor to research best practices and develop and/or update departmental policies to reflect contemporary practice and promote utilization of standard work processes.

 

Identifies and cultivates prospective future case management talent to grow a diverse and capable team. Interviews and hires in partnership with Supervisors.  Plans and coordinates competency-based orientation.

 

Assist with staff accountabilities and development: care coordination; resource management; discharge planning; utilization management; department productivity targets.  Is actively involved in the day-to-day process, and as needed based on case complexity participates on daily rounds with HCMs, patient care meetings, and reviewing cases with prolonged LOS.  Evaluation of cases regarding level of care with Denials and Appeals Coordinator and individual case managers.  Serves as a change agent and professional role model to lead team to embrace a newly designed comprehensive case manager role, championing care coordination, medical and utilization management.

 

Minimally Required Experience:

Minimum 5 years Case Management experience required. Previous supervisory and team development skills strongly preferred.

 

Skills/Competencies:

Requires a working knowledge of coordination of clinical care, discharge planning, community resources utilization management, quality review standards, activities conducted by third party payers and regulations. Ability to organize and prioritize workload in order to meet deadlines.  Must possess excellent interpersonal skills in order to interact with all levels of health care providers, support staff, and third-party payers where appropriate.  Demonstrated leadership capabilities and education skills.

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.

Education:

Bachelor of Nursing Degree (Required)

Certifications:

Registered Nurse – State of Massachusetts

Equal Employment Opportunity Employer

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