Manager Care Management RN

Swedish Health Services; Edmonds (WA); On-site; USD 141,000 - 223,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

Providence Swedish Edmonds is seeking a Manager of Case Management to lead discharge planning, utilization management and care coordination. You will supervise RN Case Managers, social workers and support staff, ensuring adherence to clinical standards and regulatory requirements.

This role emphasizes collaboration with physicians, care teams and community resources, with a focus on quality of care, cost efficiency and staff development.

Qualifications

• Bachelor's Degree in Nursing or health-related field.
• WA Registered Nurse License upon hire.
• 6 years of experience in Case Management.
• 2 years of Supervisory/management experience in Case Management.
• Nursing experience in diverse complex client care areas.
• Experience in problem-solving and conflict resolution.
• Experience in providing adult education to multi-disciplinary staff.

Responsibilities

• Direct all Case Management department activities, including supervision of RN Case Managers, Social Workers and staff.
• Guide case managers in determining level of care based on standards and admission criteria; coach staff on alternative levels of care and payment rates when needed.
• Oversee discharge processes; lead efforts to address complex discharge issues; staff coverage during high volume.
• Identify variances and take corrective action with care team collaboration.
• Collect and analyze data to assess the Case Management program effectiveness and satisfaction.
• Ensure proper documentation for regulatory compliance and develop policies to improve quality of service.
• Develop relationships with community providers to coordinate care and update reference materials.
• Manage department budget and financial controls; oversee personnel and operating budgets.
• Foster collaboration to implement evidence-based pathways and resource utilization strategies across the organization.
• Participate in performance improvement teams related to utilization, reimbursement and medical management.

Skills

RN Case Management

Supervisory experience

Case management

Problem solving

Adult education

Education

Bachelor's Degree in Nursing or health-related field

Master's Degree in Nursing or healthcare field

Job description

Description

The Manager acts as a liaison between patients and families, department staff, physicians and the healthcare team, community agencies, managed care representatives, skilled nursing facilities, community agencies. The manager is responsible for establishing, implementing and monitoring best practice and established clinical standards to assure the quality of patient care and the financial integrity of the organization.

Providence caregivers are not simply valued theyre invaluable. Join our team at Swedish Edmonds and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

• Direct all Case Management department activities, including but not limited to direct supervision of RN Case Managers, Social Workers and support staff. Provides ongoing performance feedback, a yearly written evaluation and identification / implementation of staff training needs.
• Provides guidance to case managers to determine suitability for level of care based on community standard as well as published admission and continued stay criteria. Coachs staff in finding alternative levels of care when appropriate as well as alternate payment rates when a denial is eminent. Is mindful of fiscal impact to the hospital in decision-making.
• Oversees, improves and troubleshoots processes associated with appropriate patient discharge. Leads interdisciplinary efforts to address complex patient discharge issues. Supports staff and department by sharing case management duties during times of high volume, low staffing and new and / or problem prone processes.
• Identifies variances in patients, processes and systems. Takes immediate and appropriate action to rectify variances with emphasis on collaboration with direct care providers.
• Continually collects and analyzes system and patient data to determine the effectiveness of the Case Management Program including staff and patient satisfaction measures.
• Ensures the proper documentation of all departmental activities and documentation for regulatory compliance. Develops and implements policies, procedures, protocols and standards that improve quality of service with measurable performance outcomes. Actively leads and supports process improvement activities to further enhance efficiencies and service levels.
• Develops and maintain professional relationships with community providers to promote effective coordination of care across the continuum of services. Maintains current working knowledge of community resources. Oversees the organization and development of continuously updated reference resource materials.
• Develops operational budget and institutes financial controls and measurement tools. Is accountable for personnel, operating and capital budgets for the department.
• Develops strong collaborative relationships with multidisciplinary staff and providers to develop clinically effective strategies such as evidence based clinical pathways and protocols to support and achieve the healthcare goals of the patient. Establishes effective mechanisms to support medical management related to utilization of resources throughout the organization.
• Participates as a member or leader of various performance improvement teams related to resource utilization, compliance, reimbursement and medical management. Remains current on reimbursement mechanisms and regulatory agency regulations and ensures all staff (including physicians) is updated.
• Coordinates ongoing Medical Staff education regarding the Case Management program and processes. Acts as liaison between case managers and Medical Staff to resolve issues for patient and organizational outcomes goals
• MANAGERIAL/SUPERVISORY RESPONSIBILTIES: The Manager Case Management is responsible for the daily management and organization of all activities and staff within the Case Management Department including care coordination, case management, discharge planning, utilization management, social work services, and pre-admission case management.

Required Qualifications:

• Bachelor's Degree in Nursing or degree in a health related field
• Upon hire: Washington Registered Nurse License
• 6 years of experience in Case Management.
• 2 years of Supervisory/management experience, preferably in Case Management.
• Nursing experience within a variety of complex client care areas.
• Experience and skills in problem-solving and conflict resolution.
• Experience in providing adult education to multi-disciplinary staff.

Preferred Qualifications:

• Master's Degree in Nursing or a healthcare related field upon hire:
• Certified Case Manager (CCM) or Accredited Case Manager (ACM)
• Case Management and supervisory/management experience in an acute care hospital.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission of improving the health and wellbeing of each patient we serve.

About Providence

At Providence, our strength lies in Our Promise of Know me, care for me, ease my way. Working at our family of organizations means that regardless of your role, well walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Providence Swedish is the largest not-for-profit health care system in the greater Puget Sound area. It is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. Whether through physician clinics, education, research and innovation or other outreach, were dedicated to improving the wellbeing of rural and urban communities by expanding access to quality health care for all.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern.

Company: Swedish Jobs

Job Category: Care Management

Job Function: Clinical Care

Job Schedule: Full time

Job Shift: Day

Career Track: Leadership

Department: 3905 SED CARE COORDINATION

Address: WA Edmonds 21601 76th Ave W

Work Location: Swedish Edmonds 21601 76th

Workplace Type: On-site

Pay Range: $68.01 - $107.35

The amounts listed are the base pay range; additional compensation may be available for this role, such shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Pay Range: $68.01 - $107.35

The amounts listed are the base pay range; additional compensation may be available for this role, such shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.