Clinical Case Management Manager

The University of Kansas Health System; North Kansas City (MO); On-site; USD 120,000 - 160,000; Full time

Job summary

The University of Kansas Health System seeks a Clinical Case Management Manager to lead Case Management and Continuum of Care, working with hospital leadership to ensure coordinated care and adherence to clinical standards.

Responsibilities include staff development, collaboration with physicians, and implementing process improvements to enhance patient outcomes and satisfaction.

Qualifications

• Bachelor's Degree in Nursing or Master's in Social Work.
• 5+ years of clinical nursing or healthcare experience.
• 2+ years of case management/care coordination experience.
• Preferred: Master Degree Nursing; Managed care experience.
• Licensure as LMSW or RN; BLS/BCLS certification.

Responsibilities

• Oversee daily operational management of Case Management teams and Continuum of Care.
• Collaborate with physicians and department leadership to coordinate care and improve discharge planning.
• Develop and implement policies to improve quality, efficiency and patient satisfaction.
• Ensure compliance with Medicare/Medicaid regulations and practice standards.

Education

Bachelor's Degree in Nursing

Master's Social Work

Master Degree Nursing

LMSW – State Board of Behavioral Sciences

LRN – State Board of Nursing

BLS/BCLS – American Heart Association

CMGT-BC

Job description

Position Summary / Career Interest:

The Clinical Case Management Manager, under the direction of the Director of Case Management or Director of Continuum of Care and in collaboration with the hospital leadership team; has responsibility for daily operational management of the Case Management teams, including orientation and ongoing staff development. Is responsible for planning, directing and team oversight of Case Management/Continuum of Care at The University of Kansas Hospital.

Responsibilities and Essential Job Functions

• Advocates for the protections and rights of individuals, families, communities, and populations. Supports the involvement of individuals in their own care. Supports access by individuals to their own personal health information and development of awareness of how that information may be used and accessed by others. Demonstrates skill in advocating before providers, public representatives and decision makers, and other stakeholders. Exhibits fiscal responsibility and integrity in policy development and advocacy activities and processes.
• Attains knowledge and competency that reflects current practice. Seeks experience and independent learning activities that reflect current practice in order to develop, maintain, and improve skills and competence in the manager role. Maintains professional records (e.g. portfolio) that provides evidence of competency and lifelong learning. Uses current research findings and other evidence to enhance role performance and increase knowledge of professional issues.
• Collaborates and coordinates with physicians and other department management personnel to achieve coordinated care in concert with standards of practice for the hospital and the department of nursing. This should include designing, implementing and evaluating improvements that help eliminate barriers to efficient care delivery.
• Collaborates with all levels of nursing and ancillary staff, interdisciplinary teams, leadership and other stakeholders.
• Demonstrates knowledge of Medicare and Medicaid regulation. Understanding and knowledge of admission and continued stay medical necessity criteria is essential.
• Demonstrates the ability to work with physician leadership (and/or physician-director partnerships) to promote a stronger and more effective role for physicians in the discharge planning process.
• Develops and recommends policies, procedures and/or programs and processes to improve or enhance the quality, efficiency and effectiveness of outcomes while improving patient satisfaction, physician satisfaction, and payer satisfaction at the University of Kansas Hospital.
• Evaluates own practice in relation to professional practice standards and guidelines, relevant statutes, rules and regulations. Applies knowledge of current practice standards, guidelines, statutes, rules and regulations in practice. Obtains informal and formal feedback regarding role performance from professional colleagues, representatives, and administrators. Interacts with peers and colleagues to enhance own professional practice and role performance. Takes action to achieve goals identified during the evaluation process.
• Integrates ethical provisions in all areas of practice.
• Interacts with and contributes to the professional development of peers and colleagues. Shares knowledge and skills with peers and colleagues as evidenced by such activities as presentations or talks in formal or informal meetings.
• Provides expertise and experience in the development.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelors Degree in Nursing OR
• Masters Social Work
• 5 or more years of clinical nursing or healthcare experience
• 2 or more years of case management/care coordination experience

Preferred Education and Experience

• Master Degree Nursing
• Managed care experience

Required Licensure and Certification

• Licensed Masters Social Worker(LMSW) – State Board of Behavioral Sciences upon Hire OR
• Licensed Registered Nurse (LRN) – Multi-State – State Board of Nursing upon Hire
• Basic Cardiac Life Support (BLS or BCLS) – American Heart Association (AHA)

Preferred Licensure and Certification

• Nursing Case Management Certification (CMGT-BC) – American Nurses Credentialing Center (ANCC)

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.