Mgr Case Management

Summary:

Under the general direction of the Director of Case Management provides leadership to the Case Management staff in the daily operations of the case management program. Participates in the design development implementation and improvement of the case management model at Rhode Island Hospital. Performs all essential functions with consideration of the age-specific needs of the geriatric adult and adolescent patient. Fosters patient and family centered care and nursing services in accordance with the Brown University Health and Rhode Island Hospital*s mission vision values

Responsibilities:

Provides for leadership of Acute Care Medical/Surgical Case Managers in the development implementation and evaluation of the case management program including case manager*s orientation continuing education and in-servicing programs. Participates in the interviewing process. Recommends selection of staff directs activities and evaluates professional and support staff to optimize achievement of goals and objectives. In collaboration with the Director of Case Management develops measurements for evaluating staff competencies and orientation. Acts as a resource to Case Managers and support staff. Develops department policies and strategic plans.

In collaboration with the Director Case Management Medical Director and nursing leadership identifies institutional needs and determines priorities.

Develops analyzes and adheres to departmental capital and operating budgets ensuring appropriate staffing and resources are in place to support the case management standards of practice. Provides for the effective utilization of resources (people financial material and equipment) to meet established goals and objectives.

Acts as a clinical consultant/practitioner for all members of the healthcare team regarding complex issues in areas of case management (such as hospital location appropriateness of admission and continued stay denials third party payor discharge planning

Ensures that the case management process adheres to standards of quality access and fiscal responsibility.

Develops and implements a site-specific quality improvement program to continuously evaluate the effectiveness of the case management program in partnership with the Director of Case Management and the Medical Director of Rhode Island Hospital.

Effectively and continually communicates with the staff nursing leadership management and customers to facilitate the flow of information necessary for the success of employees department families and the organization.

Facilitates continuous performance improvement by encouraging innovation supporting reasonable risk-taking and maintaining openness to new ideas.

Participates in ongoing independent study education-related professional activities affiliations to maintain knowledge in the area of patient care services third party payor and managed care requirements and case management.

Participates in or leads various committees task forces and quality improvement teams as needed.

Other information:

Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.

QUALIFICATIONS-EDUCATION:

Must have current licensure to practice as a Registered Nurse in the State of Rhode Island.

Bachelor*s degree in Nursing or equivalent.

Masters degree in Nursing or level of preparation preferred.

Understands the provisions of the Nurse Practice Act of the State of Rhode Island.

Demonstrated knowledge and skills necessary to provide care to patients throughout the life span with consideration of the aging process human developmental stages and cultural patterns in each step of the care process.

Working knowledge of quality assurance utilization management hospital reimbursement and capitation methodologies is required.

Demonstrated ability to identify and negotiate boundaries of accountability and authority within multiple disciplines.

QUALIFICATIONS-EXPERIENCE:

Five year*s relevant clinical/case management experience with demonstrated leadership skills.

Experience should demonstrate a high level of written and oral communication skills. Knowledge of Utilization Review Criteria.

SUPERVISION:

Direct or indirect supervisory responsibility for up to 45 FTEs.

Supervision includes interviewing hiring scheduling training conducting performance appraisals recommending personnel actions and as necessary corrective actions.

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: Rhode Island Hospital USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union