Summary

Oversee the delivery of consistent, high quality and patient centered care, promote the professional growth and development of the Case Managers and Clinical Social Workers, and develop operational efficiencies. Ensure case management practices comply with department, hospital, and regulatory policies, procedures and professional standards of practice. Develop, implement, and maintain Case Management Department Standards of Practice and Policies and Procedures. Serve as a liaison and resource for the Program Directors, Nurse Managers, Therapy Directors, Physicians and other clinical and non-clinical services and departments within the organization in the areas of case management and social services. Participate in quality improvement and program development activities. Participate in development and assurance of general and program specific competencies as it relates to the patient population served.

Key Responsibilities

• Team members are hired, mentored, and continually developed to achieve stated goals for performance.

• Performance evaluations are completed accurately and timely in accordance with organization standards.

• Staff orientation is developed, conducted and evaluated to meet department standards.

• Business plan is aligned with PCC strategy and is updated at least annually to drive change to meet market and organizational goals in collaboration with Case Management Director.

• Direct clinical practices are managed to ensure compliance with all regulations and achievement of targeted quality, service and financial outcomes.

§ Compliance audits are conducted to ensure adherence to department standards of practice, policies and procedures.

• Department quality improvement projects are actively engaged in to achieve established objectives.

• Work assignments are distributed equitably among team members and meet the needs of the department.

• Staffing schedule is developed and maintained to ensure coverage meets anticipated needs.

• Potential long length of stay patients are monitored to resolve barriers to discharge and support is provided to team members to achieve length of stay targets.

• Denials and appeals are reviewed within established timeframes.

• Established department goals are achieved through active participation in Utilization Review Committee.

• Case Management Department Standards of Practice, Policies and Procedures are developed and implemented in collaboration with Case Management Director.

• Committee leadership and engagement drives achievement of organizational and department goals.

• Additional department, organization, or network activities are completed per established objectives.

• PCC Organizational Values of Innovation, Collaboration, Accountability, Respect, and Excellence are upheld.