Complex Case Manager Care Coordination

bannerhealth; Tucson (AZ); On-site; USD 75,000 - 105,000; Full time

Job summary

Banner Health’s Banner - University Medical Center Tucson in Tucson, AZ seeks an experienced Complex Case Manager to coordinate care for a caseload of patients with complex medical and psychosocial discharge needs. The role offers autonomy in a fast-paced hospital environment and reports to the Director with collaboration with physician leaders.

The ideal candidate has strong communication, critical thinking, and flexible problem-solving skills to adapt to evolving department needs and to serve

Qualifications

• RN: Bachelor's degree in case management or health care and RN license.
• Social Worker: MSW and LMSW/LCSW or equivalent licensure within 6 months.
• BLS certification may be required for acute care assignments.

Responsibilities

• Manages individual patients across the health care continuum to achieve the optimal clinical care, financial, operational, and satisfaction outcomes.
• Acts in a leadership function with process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
• Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient discharge plan. Effectively communicates the plan across the continuum of care.
• Maintains knowledge of Medicare, Medicaid and other program benefits to assist patients with discharge planning and choices. Knowledge of community resources relevant to health care, end of life dynamics, substance abuse, abuse, neglect, and domestic violence.
• Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.
• Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice.

Skills

Critical thinking

Problem-solving

Communication

Time management

Interdisciplinary teamwork

Education

Bachelor's degree in nursing or health care

Master's Degree in Social Work

Job description

Primary City/State: Tucson, Arizona

Department Name: Case Mgmt-Hosp

Work Shift: Day

Job Category: Clinical Care

The future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. If you’re ready to change lives, we want to hear from you.

We are seeking an experienced acute care hospital Complex Case Manager to join our dynamic team, where you'll leverage your critical thinking and creative problem-solving skills to manage a caseload of 20-25 patients with the most complex medical and psychosocial discharge planning needs. This role offers a high level of autonomy in a fast-paced hospital environment, reporting directly to the Director with regular collaboration alongside physician leaders and the ACMO. The ideal candidate will bring exceptional communication skills, the ability to think "outside the box," and a flexible approach to meeting evolving department needs while serving as a trusted resource to peers. If you're looking for a challenging position where you can influence outcomes, drive results that align with hospital goals, and make a meaningful impact on patients facing the most difficult discharge scenarios, this opportunity is designed for you.

SCHEDULE

• Full Time/ 40 Hours
• Monday-Friday
• 5 Eight hour shifts
• 8:00am- 4:30pm or 8:30am- 5:00pm

Banner - University Medical Center Tucson is nationally recognized for providing exceptional patient care, teaching future health-care professionals and conducting groundbreaking research. Also located on the campus is Diamond Children’s - recognized for its specialized pediatric services including neonatal and intensive care, emergency medicine and cancer therapies. Banner - University Medical Center Tucson is a Level 1 Trauma Center, meaning we care for the most critically injured patients. The hospital is consistently listed among the nation's top hospitals in the prestigious Best Hospitals ranking by U.S. News & World Report. The academic medical center has earned Magnet Recognition becoming the only hospital in southern Arizona to meet the rigorous standards of the American Nurses Credentialing Center’s Magnet Recognition Program® for nursing excellence. The hospital's physicians are full-time faculty of the University of Arizona College of Medicine - Tucson. Our specialty services include comprehensive heart and cancer care, advanced neuroscience techniques and a multi-organ transplant program.

POSITION SUMMARY

This position provides comprehensive care coordination for patients as assigned. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the clinical quality of Care Coordination services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care. The goal is to empower the patient and the family to participate to the fullest of their abilities in the discharge planning process. This position provides developmentally appropriate care for the population that it serves which includes planning for the safe discharge, continuity of care, the ability to recognize and plan for the unique needs of all ages as well as the physically disabled, mentally ill, chronically ill and terminally ill patient.

CORE FUNCTIONS

1. Manages individual patients across the health care continuum to achieve the optimal clinical care, financial, operational, and satisfaction outcomes.
2. Acts in a leadership function with process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
3. Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient discharge plan. Effectively communicates the plan across the continuum of care.
4. Maintains knowledge of Medicare, Medicaid and other program benefits to assist patients with discharge planning and choices. Knowledge of community resources relevant to health care, end of life dynamics, substance abuse, abuse, neglect, and domestic violence.
5. Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.
6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice.
7. May supervise other staff.
8. Has freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are entity based with no budgetary responsibility. Internal customers: Patients, families, all levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External Customers: Physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies.

MINIMUM QUALIFICATIONS

RN: Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse (R.N.) license in state worked.

Social Worker: Requires a Master's Degree in Social Work. Requires a Licensed Master Social Worker (LMSW) (equivalent*) or Licensed Clinical Social Worker (LCSW) or have a MSW with the requirement to become licensed within 6 months of hire date. An equivalent license applies to states that do not recognize an LMSW; therefore, the employee must possess a Master's Degree and be a Licensed Social Worker.

For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.

Requires a proficiency level typically achieved with 2 years clinical experience. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format. May have to take rotating call based on the acute facility need. For Case Management positions in acute facilities, Banner Registry and Travel positions require a minimum of one year Case Manager experience in an acute care hospital.

PREFERRED QUALIFICATIONS

Certification for CCM (Certified Case Manager) preferred.

Additional related education and/or experience preferred.

EEO Statement

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.