JOB TITLE: VICE PRESIDENT OF CASE MANAGEMENT
REPORTS TO: REGIONAL VICE PRESIDENT
CATEGORY: EXEMPT
GENERAL DESCRIPTION
The role of the Vice President of Case Management encompasses various responsibilities. The primary objective is to ensure that patients receive timely and appropriate visits from the appropriate healthcare providers. The Vice President of Case Management also focuses on maximizing staff productivity and utilizing effective tools to facilitate proactive healthcare. Additionally, the position is responsible for maintaining optimal staffing levels within the care teams. This involves overseeing and promoting the proper utilization of tools such as chronic care management, transitional care management, advanced care planning, cognitive behavior screening, laboratory tests, X-rays, and other screening tools. Overall, the Vice President of Case Management plays a crucial role in optimizing patient care, ensuring efficient utilization of resources, facilitating interdisciplinary teamwork and care coordination amongst the region care teams, and maintaining compliance with regulatory standards.
AREAS OF RESPONSIBILITY
A successful Vice President of Case Management will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.
The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).
• Leadership and Administration: Provide strategic direction and leadership to the regional staff, setting goals, developing policies and procedures, performance management, and ensuring adherence to regulatory standards.
o Develop and implement effective case management policies, procedures, and workflows to optimize patient care, staff productivity, and proactive healthcare practices. This includes ensuring timely and suitable visits by the right healthcare providers, utilizing appropriate tools, and maintaining well-staffed care teams.
o Oversee the operations of the case management program, including managing patient visit schedules, maximizing provider availability, and ensuring visits are warranted.
o Supervise the Director of Clinical Services, who oversees the care teams consisting of case managers, clinical coordinators, and providers.
o Ensure adequate staffing levels within care teams to meet the needs of patients.
o Contribute to strategic planning and goal setting initiatives for the organization.
o Foster a culture of collaboration, innovation, and continuous improvement within the organization.
o Continuous Improvement: Actively seek opportunities to improve scheduling process and propose innovative solutions to enhance patient outcomes, productivity, and patient satisfaction/experience.
o Utilize the company’s software systems to enhance patient care and staff productivity. Participate in coaching calls.
• Care Coordination: Oversee the coordination of patient care and collaborate with physicians, nurses, and other healthcare professionals to develop comprehensive care plans and facilitate effective communication among the care team.
o Monitor and encourage the appropriate utilization of proactive healthcare tools, such as chronic care management, advanced care planning, and various screening methods (e.g., cognitive behavior screening, labs, x-rays).
• Quality Improvement: Implement quality improvement initiatives to enhance patient experience, outcomes and satisfaction. This may involve analyzing data, identifying areas for improvement, and implementing practices to optimize care delivery.
• Utilization Management: Oversee utilization review processes to ensure appropriate and efficient use of healthcare resources.
• Training, Supervision, and Staff Development: Provide leadership and support to regional staff, including training, mentoring, oversight, and professional development opportunities.
o Provide training and guidance to case management staff, ensuring they understand scheduling
2
protocols, customer service standards, and proper use of company’s software systems.
o Participate in interviews and hiring for regional staff.
o Perform supervisory duties for regional staff, in conjunction with other leadership, such as completing necessary forms, reports, evaluations, hiring/termination, productivity review, training, etc.
o Monitor and evaluate the performance of case managers and assess the overall effectiveness of the case management program.
o Provide ongoing training and education opportunities for case managers, clinical coordinators, and providers.
• Customer Service: Provide exceptional customer service to patients, exhibiting a compassionate and empathetic attitude. Address patient concerns, inquires, and complaints professionally and promptly, striving to meet patient needs and ensure their satisfaction.
• Collaboration and Coordination: Collaborate with various departments and leadership to facilitate and ensure seamless operations.
• Perform other duties as requested or required, in the sole discretion of the Company.
MISSION EXPECTATIONS
• Take responsibility for own work in completing tasks. Assist others so that the resources, assistance or support is provided to achieve success in their daily work.
• Communicate, endorse, and demonstrate the Company’s mission, vision and values.
• Prompt and regular attendance.
• Adhere to standards of behavior, dress code including name tag and approved uniform, personnel department and company policies.
• Attend in-services and meetings on a regular basis.
• Promote a culture of outstanding customer service and strive to enhance patient experience at all times.
• Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and/or projects.
• Must possess the ability to deal tactfully with patients, employees, management, visitors, government agencies, and the general public and maintain an open-door policy for all employees.
• Must possess the ability to make independent decisions when circumstances warrant.
WORK ENVIRONMENT
The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job:
• May be exposed to housekeeping cleaning agents and chemicals, humidity, hot equipment, and/or noise.
• May be exposed to infections, communicable diseases, odors, bloodborne pathogens, excreta and hazardous materials.
COMPLIANCE WITH POLICIES AND PROCEDURES
• Comply with all federal, state and local laws and regulations.
• Knowledge of and compliance with Patient’s Bill of Rights.
• Must be knowledgeable of Medicare guidelines, applicable laws and regulations, and the Company’s policies and procedures.
• Adhere to the Company’s Code of Conduct / Ethics.
• Must exercise a high degree of confidentiality regarding patients, personnel and the company.
• HIPAA compliant.
• Promote a culture of compliance.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.
• Must be able to lift, reach, bend, push, pull, use repetitive hand motions, walk and carry simultaneously.
• Must be able to withstand reaching, stooping, bending, kneeling, and crouching; walking and standing for periods
3
of time; lifting up to fifty (50) pounds.
• Must be in good general health and demonstrate emotional stability.
QUALIFICATIONS
• Degree Requirements: bachelor’s degree in healthcare administration/management, social work, nursing or related field required. Master’s degree in healthcare administration, social work, or nursing preferred.
• Experience Requirements: Minimum of 7 years in case management or related field and a minimum of 3 years in leadership.
• Demonstrated success in developing and implementing case management programs.
• Strong organizational and time management skills, with the ability to multitask and prioritize responsibilities effectively.
• Ability to manage and demonstrate effective leadership skills.
• Should demonstrate strong interpersonal and communication skills under all conditions and circumstances.
• Ability to foster a cooperative work environment and work collaboratively with other department heads, leadership, and key stakeholders.
• Strong analytical and problem-solving skills.
• Demonstrated commitment to quality improvement and patient-centered care.
• Team player with ability to manage multiple responsibilities and demonstrate sound judgment.
• Ability to read and communicate effectively.
• Strong written and verbal skills.
• Basic computer knowledge.
• Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order.
I have received, reviewed and understand the requirements of this job, and agree that I can perform the requirements of this position. I accept the position and agree to perform in accordance with established policies and procedures, and all Federal, State and local laws, regulations, codes and accepted professional standards and principles that apply. I understand that if I require a reasonable accommodation to perform any essential function of my job, I will clearly communicate that to Human Resources. Every effort has been made to make your job description as complete as possible. However, it in no way states or implies that these are the only duties you are required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar or is a logical assignment of the position, in the sole discretion of the Company. This job description does not constitute a contract of guaranteed employment for any period of time. I understand that my employment is at-will and that I can be terminated at any time