The Manager of Case Management coordinates all aspects of clinic-based case management to promote patient-centered care, balance optimal care, and manage resource utilization.
Duties and Responsibilities :
- Serve as a case management subject-matter expert, advisor, and leader for the case management team.
- Supervise, facilitate, and oversee staff development and daily department activities and tasks.
- Collaboratively work and maintain active communication with the primary care practitioners and other members of the care team to achieve timely, appropriate patient management.
- Effectively communicate with patients, family, medical staff, care team members, students, supervisors, and external contacts as needed.
- Monitor the quality of case management interactions with patients, families, physicians, and multidisciplinary teams by regularly shadowing staff to ensure clear understanding and adherence to department processes.
- Regularly audit case management associates’ documentation to monitor quality of documentation, productivity, and assessments.
- Schedule and staff department, department education, and competencies.
- Complete daily, weekly, and monthly reports as assigned by the Director of Case Management.
- Adhere to established policies, procedures, and standards of care.
- Promptly escalate issues through established chain of command.
- Demonstrate knowledge of CMS and Medicaid requirements, quality and HEDIS initiatives, health plan processes, and compliance policies.
- Serve as an advocate for patients’ rights, needs, and values; ensuring that patients’ ethnic, cultural, or religious values, beliefs, preferences, and needs are considered.
- Perform other duties as assigned.
Qualifications / Education / Licenses
- Registered Nurse with current state licensure, BSN preferred.
- Three years of clinical, hospital nursing experience required.
- Three to five years' previous case management experience required.
- One to two years of supervisory experience preferred.
- Case Management certification desirable
- Bilingual in English and Spanish preferred.
At Clinical Care Medical Centers, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, military and veteran status, and any other characteristic protected by applicable law.
Clinical Care Medical Centers believes that diversity and inclusion among our employees is critical to our success as a company.
We support an inclusive workplace where employees excel based on personal merit, qualifications, experience, ability, and job performance.
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