Manager Care Management AdventHealth Heart of Florida

Location Address: 40100 US Hwy 27, Davenport, FL 33837

Top Reasons to work at AdventHealth Heart of Florida

• Close proximity to Walt Disney World
• Various outdoor activities for families and children to enjoy
• Beautiful local golf courses available year round
• Faith-based work environment
• Great benefits

Work Hours/Shift:

• Full Time Days

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

• Supports the daily operations of the Care Management department (both Inpatient and Emergency Department settings)
• Implements Corporate Care Management strategies
• Implements strategies with a focus on customer experience
• Ensures documentation compliance of the Care Management department (Discharge Planning Evaluation, IMM, MOON, Patient Choice, etc.)
• Identifies and utilizes resources to support information sharing amongst staff
  • Actively participates in daily Multidisciplinary Runds ensuring staff participation on their assigned units to discuss transition of the patient to the post­ acute setting and barriers to the plan
  • Assures staff dcumentation is completed per guidelines as evidenced by appropriate monitoring techniques, coaches staff as needed
• Assures patients are routinely assessed for post-hospital needs and documentation occurs within 1 calendar day of patient admission
• Advocates and escalates pace of care delays
• Assures discharge plans are developed in collaboration with patient, family caregivers, care team and payor
• Assures effective discharge planning to meet patient needs, meet regulatory requirements and achieve organization objectives related to readmission reduction
  • Supprts implementation of processes as directed by system for identification of at-risk populations and acquires necessary resources/services to improve patients' chances of successful self ­management
• Coordinates and leads family meetings and patient/family and care team meetings as needed
• Strives to meet all key performance indicator (KPI) targets
• Assesses, develops, implements, monitors processes that impact patient outcomes
  • Seeks opportunities for improvement in quality of care/services
  • Reports pertinent quality/risk issues to appropriate individuals, departments and/or committees in a timely manner
  • Participates on performance improvement teams as appropriate
  • Monitors and documents activities ongoing to substantiate the effectiveness of care management activities to achieve compliance with external agencies
  • Collaborates with outside agencies to guide the hand­over of patients to the post-­acute setting
  • Escalates operational and/or financial concerns to the Physician Advisor(s) as appropriate
  • Participates, as needed, in hospital/medical staff meetings to review patients meeting criteria related to high dollar/extended length of stay and/or difficult placement; maintains meeting minutes as appropriate
• Assists in the development and oversees the implementation of Care Management policies, procedures, and standards
• Plans, organizes and delegates activities as required for safe, efficient and effective operations of the unit/area including active participation with other hospital and leadership staff to accomplish this purpose
• Encourages team member engagement
• Holds regular staff meetings; and encourages staff to share information and participate in decision making
• Maintains excellent professional relationships with facility and divisional leadership
• Communicates and collaborates across the Care Management team in the areas of data and information management, performance improvement, care coordination, care transition management, medication management, and social services
• Monitors and meets productivity standards and staffing needs
• Fosters a work environment favorable to retaining staff
• Responsible for personnel functions including staffing, performance reviews and corrective action
• Promotes professional growth and development of employees
• Maintains a predictable schedule, including time on and off shifts such as weekends and holidays
• Maintains collegial relationships with staff, physicians, and other departments
• Maintains open communication with staff
• Hires and retains individuals with appropriate skills and works to develop staff to their highest potential
• Assures personnel policies are understood and adhered to
• Consults with Care Management Facility Director and Human Resources for performance issues as appropriate
• Fosters professionalism, independence and critical thinking
• Demonstrates a positive problem-solving attitude to staff, physicians and peers
• Supports financial responsibility of Care Management and viability of department resources
• Assists in development of an action plan to address variances (positive and negative)
• Supports flexible scheduling to meet the needs of staff members, and achieve productivity while remaining within budget
• Formulates contingency plans for staffing during times of low census

EDUCATION AND EXPERIENCE REQUIRED:

• Registered Nurse: BSN or
• Social Worker:  BSW + Masters in related field
• 3 years in direct Care Management/Utilization Management experience in an acute care setting

EDUCATION AND EXPERIENCE PREFERRED:

• Registered Nurse:  BSN + Masters in related field
• Social Worker: MSW + LCSW
• 2 years of supervisory/lead/manager level of responsibility experience

LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:

• State specific RN license if a nurse

LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

• RN-BC Certification in Care Management
• LCSW

Job Summary:

The Care Management Manager is under the general leadership of the Care Management Facility Director and has the responsibility of the departmental daily operations and supervision of team members.

The Care Management Manager is responsible for, but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Social Services implementation of processes based upon data management, accountability for Length of Stay, Excess Days, Avoidable Days, Readmission Prevention, and Discharge Planning. In addition, the Care Management Manager is responsible for department engagement, customer experience, compliance of regulatory standards, and employee evaluations. The Care Management Manager supports professional and collaborative relationships with the Interdisciplinary Team to sustain process improvement and attain hospital metrics.