Case Management Manager

TITLE 

Manager, Case Management

POSITION SUMMARY

Individual reports to the director of Clinical Operations for all operational issues and the AMM or SVP clinical operations for all clinical issues. The case management manager is critical to the success of AMM and as such is responsible for the implementation and ongoing management of all the AMM case management programs. The manager will provide guiding principles, interventions and strategies that are targeted at the achievement of client stability, wellness, and autonomy through advocacy, assessment, planning, communication, education, resource management, care coordination, collaboration, and service facilitation. 

RESPONSIBILITIES-DUTIES

• Review Inpatient cases and provides guidance to IP case managers for reviews, hospital transfers, observation, discharge planning, and transitions of care.
• Review outpatient cases and provides guidance to OP case managers for reviews, case management program overview and following the processes for disease management, complex case management and the management of DSNP. 
• Responsible for inspiring the team to come up with creative ways to keep patients out of the hospital and have the best quality of care at home or in a care facility.   Lead Monday nurse team meetings.  
• Identifies, develops, and oversees the educational needs of the team and motivates and leads the team in setting and reaching goals for improvement. 
• Work with the team to enhance the systems case management use.
• Involved in the projects for the platform development for case management.
• Recruits and retains CM team members.
• Conducts annual performance appraisals.
• Provides coaching and disciplinary activities with staff.
• Participates in budget preparation if needed.
• Analyzes staffing ratios and productivity levels.

EDUCATION AND EXPERIENCE REQUIREMENTS 

• Have deep compassion for patients and the care they receive.
• Valid California RN or LVN license
• Bachelor’s degree strongly preferred, master’s degree in nursing or health – Related Major preferred.
• CCM desirable   
• Minimum of 5 years of UM and CM experience in an IPA/PMG or HMO setting or equivalent education combined with experiences in direct patient care settings such as SNF or inpatient settings
• Experience in management (hiring, counseling, terminations) strongly preferred
• Maintains confidentiality and adheres to HIPAA policies. 
• Managerial skills necessary to independently manage on-site as well as remote teams.