Manager of Case Management

Job Purpose & Position Overview

This position is responsible for providing oversight of the Case Management Department. This includes the ability to work in all case management areas and be a working part of the case management team.

Specific Job Duties/Responsibilities

• Demonstrates the WCHS core Mission, Vision and Values.
• Communicates with providers and the case management team to initiate and coordinate all case management services as needed.
• Serves as a mentor to all on the case management team on an as needed basis.
• Maintains the Case Management team schedule.
• Responsible for initiating and being in charge of monthly, and as needed staff meetings to communicate organizational and departmental goals.
• Responsible for implementing the orientation process for the case management team.
• Evaluates individuals on the case management team as part of the human resources performance management process.
• Monitor daily census logs to identify patients with high or improper utilization of services that may benefit from care coordination assistance.
• Monitors referrals and assigns to appropriate staff members
• Assisting Patients in accessing and completing follow-up care.
• Assuring all relevant information is needed to complete Purchased Referred Care reviews and referrals.
• Perform utilization management reviews when required.
• Conduct initial comprehensive assessment of Patients’ needs and support systems.
• Work with a multidisciplinary team to develop a comprehensive, patient centered plan and coordination of the services required for implementation of plans for clients.
• Monitor to assess the efficacy of the plan and periodic re-evaluation and revision of the plan as necessary.
• Ensure client’s compliance with treatment plan including medications and education as necessary.
• Coordinating transitions of care when appropriate to meet the Patients’ medical or psychosocial needs.
• Assist clients in applying for Social Security benefits and other types of entitlement programs.
• Refer appropriately to Patient Benefits and Social Service agencies.
• Maintain assigned Patients’ medical and service record files and be responsible for files completeness, including presence of outside records.
• Recording all information and interactions as appropriate in the EHR.
• Works closely with other members of the case management team, to ensure delivery of care in the event of absence of a team member.
• Build and maintain relationships with both internal and external care partners to facilitate Patients’ care.
• Participates in community updates and meetings as requested.
• Identifies improvement opportunities and ensures data is collected and submitted for quality improvement activities.
• Facilitates and/or participates in utilization review, and quality assurance meetings.
• Attends any hospital wide required meetings; also attends the multidisciplinary team meetings as needed.
• Generates reports and statistics when requested to show the impact of the case management program.
• Assists in the creation and maintenance of relevant policies and procedures
• Participates in community updates and meetings as requested.
• Updates job knowledge and keeps track of case management trends by participating in educational opportunities, reading professional publications, maintaining personal networks, and participating in professional organizations.
• Enhances department and organization reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
• Improves financial status by analyzing results, monitoring variances, identifying trends, identifying and helping to complete grant and subsidy applications, and recommending actions to management.
• Performs other duties as assigned.

Required Qualifications/Skills:

• Minimum of Associates Degree in Nursing required, Bachelor's Degree preferred.
• 3-years experience as a case manager or combination of education and applicable experience.
• Supervisory or leadership experience preferred.

• Currently licensed as a Registered Nurse in the State of Nebraska or multi state licensure in a nurse licensure compact state.
• Current Certification in Basic Life Support (BLS)
• Must have excellent communication skills and can relate easily to both patient and providers.

 Training Requirements:

• Case management training on an annual basis.
• Completion of all required training as assigned

 Physical Requirements:

• Normal to light office work which includes the ability to lift up to 10 lbs.
• Regularly required to walk, stand, and sit for extended periods of time and use hands to operate computer keyboard, phone, and various office equipment.

 Cognitive Requirements:

• Reading, writing, calculating
• Above average social interaction skills
• Reasoning/Analysis
• Works with minimal to no supervision

 Language Requirements:

• Must possess the ability to read, write, and speak the English language fluently.
• Must be able to continually and effectively employ professional verbal and written communications skills.

 Certificates, Licenses & Registrations:

• All applicants will comply with 45 CFR 1301, Subpart D, Section 1301.31, C and D, which require all prospective employees to sign a declaration prior to employment regarding all arrests and convictions of child abuse or violent felonies and to comply with PL 101-630 and PL 101-637 regarding criminal records check.

WCHS is an equal opportunity employer. Employment practices are free of discrimination. As provided by Federal Law, all qualified Native American applicants shall receive preference over Non-Native American applicants. In the absence of qualified Native American applicants, consideration will be given to all other applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, veteran status, genetic information, disability or any other reason prohibited by law in provision of employment opportunities and benefits.

 Please note the position description duties, responsibilities, and activities may change at any time with or without notice.