Job Description
Additional Job Information
Physical Requirements
•Climbing – 26-75%
•Grasping, Pinching and Holding – 26-75%
•Lifting or Carrying – 26-75%
•Pushing or Pulling – 26-75%
•Reaching Overhead – 0-25%
•Sitting – 76-100%
•Squatting, Bending, Kneeling – 26-75%
•Standing – 26-75%
•Walking or Moving – 0-25%
•Weights Lifted 10-35 lbs.
Overview
Job Responsibilities:
Sets direction for Case Management/Social Services/Utilization Review which supports strategic and operational plans, and overall healthcare trends, by establishing goals and outcomes that are aligned with performance expectations and establishing targets and processes to support initiative of clinical quality and length of stay.
Provides leadership and communication to maintain a competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, completing performance appraisals, conducting new hire feedback sessions, coaching/corrective counseling, and providing recognition/commendations to achieve desired outcomes.
Ensures that the productivity and actions of that group meet/support the overall operational goals of the department and hospital as established by department leadership.
Develops and adheres to departmental staffing, revenue and/or expense budgets. Responds to the changes in the business which may affect the ability to achieve budget goals.
Participates in or leads, multidisciplinary initiatives deemed appropriate for this department’s participation.
Address patient complaints, conducts physician education regarding discharge planning, progression of care, documentation of improvement, and Medicare Conditions of Participation.
Partners with physicians, quality, palliative care, and other departments to identify strategies to improve the mortality index and readmission of patients.
Identifies initiatives to progress patient care, work with the interdisciplinary team to ensure a safe and efficient discharge plan, as demonstrated by system goals, i.e. avoidable days.
Ensures that outcomes management activities are integrated and maintained in a clinically appropriate manner. Identifies and plans strategies to reduce length of stay and resource consumption while providing excellent customer/patient service.
Plays a leadership role in utilization review committee which includes identification of opportunities for appropriate utilization of resources to avoid denials and resource management as it pertains to delivery of care.
Boone Health has determined this is a safety-sensitive position. The ability to work in a constant state of alertness and in a safe manner is an essential function of this job.
Performs Other Responsibilities as Assigned.
Minimum Qualifications:
Degrees: Master's degree in nursing or business or must be able to obtain within one year; must be currently enrolled in a degree program at time of hire/transfer.
Or a current master’s degree in social work.
Experience: 5 Years in CM/SW or UR
Supervisor Experience: Five years of people management experience in a healthcare environment, preferably a hospital or health system.
Licenses & Certifications:
RN - Registered Nurse (preferred) - Missouri State Licensure and/or Compact State Licensure AND
CCM - Certified Case Manager within 1 year OR
ACM - Accredited Case Manager (NBCM) within 1 year OR
ACM - Accredited Case Manager (ACMA) within 1 year OR
ACM - Accredited Case Manager within 1 year OR
If not an RN: MSW-Masters Social Work-Missouri State licensure.
Preferred Qualifications:
Master’s degree
5 Years of CM/SW or UR experience in a hospital setting
5 Years of people management experience
Work Shift
Day Shift (United States of America)
Scheduled Weekly Hours
40
Legal Statement
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.
Equal Opportunity Employer