The Clinical Resource Management (CRM) Manager actively promotes case management principles while managing day to day interaction with the Care Manager, Utilization Review, Access Utilization Review, Post Acute Care Coordination members, and Social Services of the Clinical Resource Management team. The Manager will specifically monitor and evaluate staff in the areas of progression of care, appropriate next level readiness designation and effective discharge planning. Additionally, specific monitoring and evaluation of staff in the areas of patient education, assessment skill, effective communication, clinical competency, and interpersonal behavior will be completed by the Manager. This person will be available to the physician advisors (PA) to assist with documentation reviews and rounding when necessary. The CRM Manager acts as the main departmental liaison between hospital payors and providers as it relates to UM program adherence. He/she will monitor program effectiveness and recommend improvements as needed. New program enhancements will be directly led by the CRM Manager with collaboration from the Director and Medical Director. This person will also effectively communicate program effectiveness and external payor requirements to other hospital departments. The individual will work closely with the Director to promote case management principles throughout the organization.

• A minimum of 5 years of nursing or social work experience is required.
• Previous experience with Case Management & Utilization Management required.
• Previous management experience preferred.
• BSN required for nurses, LSW or LCSW required for those with a social work background

• C urrent Illinois State License as a registered nurse or Illinois state license as a Licensed Social Worker or Licensed Clinical Social Worker.
• Current CPR certification with re-certification annually preferred.

Responsibilities:

• Actively promotes CRM practicies with internal and external clientele.
• Assists the Director with external accrediting/government relations.
• Assists with the development, implementation, and maintenance of Clinical Resource Management Department policies.
• Communicates pertinent hospital and patient care information to staff.
• Contributes to overall department quality improvement initiatives.
• Creates environment of teamwork and collaboration to improve staff satisfaction and enhance retention.
• CRM Manager is responsible for assigning and/or completing Medicare one day stay queue, completing daily SMR, and reporting on Outpatients Inhouse w/LOS daily census.
• Develops and promotes new programs to strengthen Riverside's overall reputation and market position.
• Directly supervises staff in day to day operations.
• Participates in CRM staff performance reviews and provides feedback as requested.
• Establishes and maintains excellent physician relationships and works to resolve medical staff problems in a timely manner.
• Establishes and monitors unit productivity and ensures appropriate staffing at all times.
• Integrates the departments into the mainstream of Riverside HealthCare in support of the organizational mission.
• Maintain education, training and staff's knowledge of regulations guiding their roles.
• Ensure staff's usage of on-line education and credentialing opportunities and requirements.
• Manages and provides leadership in financial matters regarding budgeting and cost control and revenue generation.
• Other duties as assigned.
• Oversee and manage accurate and timely appeals and follow-up of all governmental audit processes. (i.e., RAC, MAC, Medicaid RAC, etc.)
• Participates and contributes to assigned committees, teams, task forces, including community service if applicable.
• Provides leadership and direction for improving patient/customer satisfaction and ensuring quality patient care.
• Serves as coordinator to CMs, URS, AURS, and PACCs hired into the Clinical Resource Management Department.
• Serves as the facilitator for the daily CRM team meetings.
• Suggests or recommends changes in plan of care based on nursing interactions with patient/family.
• Support/assure development and maintenance of nurse/physician collaboration.

Riverside Healthcare is revolutionizing care using leading-edge technology to diagnose and treat patients. We are ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery and have also been named one of the nation's 100 Top Hospitals by Truven Health Analytics seven times. Riverside is nationally recognized for our specialty programs in obstetrics, trauma, oncology, rehabilitation, geriatrics, occupational health, psychiatric services, and treatment of alcohol and chemical dependency, as well as patient safety. We combine innovation and convenience at state-of-the-art facilities located in communities throughout the greater Kankakee area.

Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago's southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedications is respected, where superior performance is rewarded with competitive salaries and excellent benefits.

Other information:

Exposure/Sensory Requirements

Exposure to:
Chemicals: White out for correction of typing/writing corrections.
Video Display Terminals: Average
Blood and Body Fluids: Low risk
TB or Airborne Pathogens: Low risk.

Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Required to communicate with physicians, hospital staff, and outside agencies.
Vision: Needed to perform chart review data, computer screen work, reading data and information.
Smell: NA
Hearing: Needed for telephone communication.
Touch: Needed to write, computer entry, individual pages of chart for review.

Activity/Lifting Requirements

Average Hours per Week: 40

Shift: Days

Percentage of time during the normal workday the employee is required to:
Sit: 70%
Twist: 2%
Stand: 10%
Crawl: 0%
Walk: 9%
Kneel: 1%
Lift: 4%
Drive: 0%
Squat: 1%
Climb: 0%
Bend: 2%
Reach above shoulders: 1%

The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Not Required
Up to 20 lbs: Not Required
Up to 35 lbs: Not Required
Up to 50 lbs: Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):

Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 120
Twist: 1
Stand: 30
Crawl: 0
Walk: 10
Kneel: 1
Lift: 5
Drive: 0
Squat: 1
Climb: 0
Bend: 2
Reach above shoulders: 1

Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight: 80%
Pushing & pulling Normal weight:
Fine Manipulation: Computer entry, writing.

Repetitive use of foot or feet in operating machine control: None

Environmental Factors & Special Hazards

Environmental Factors (Time Spent) :
Inside hours: 8
Outside hours : 0

Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere: Odors, Dust

Special Hazards : NA
Protective Clothing Required: None