Program Manager Care Management - Case Management

CHRISTUS Health; Beaumont (TX); On-site; USD 85,000 - 110,000; Full time

Job summary

CHRISTUS Health is seeking a Program Manager for Care Management to oversee patient flow, discharge readiness and interdepartmental collaboration. You will coordinate communications among physicians, nursing, and leadership to remove discharge barriers and reduce delays in care.

The role emphasizes education on throughput, adherence to HIPAA guidelines, and driving process improvements across the hospital to enhance access to care for the community.

Qualifications

• Education in nursing, social work, or other applicable health care concentration.
• 3+ years of experience in case management in the acute care setting.
• License to practice in the state of employment (or compact); Certification in Case Management preferred.

Responsibilities

• Meets expectations of OneCHRISTUS competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Oversees and optimizes patient flow within the hospital.
• Identifies and addresses bottlenecks to ensure timely transitions and discharges.
• Educates physicians and clinical staff on clinical guidelines for medical necessity.
• Monitors throughput via discharge planning metrics and identifies opportunities for improvement.
• Drives length of stay reduction and optimization by mitigating discharge barriers.
• Coordinates information exchange among hospitalist groups, nursing, Care Management, ED personnel, and ancillary departments.
• Prepares for daily morning huddle with discharge orders and notifies teams when present.
• Tracks patients in observation status and escalates when conversion to inpatient or discharge is identified.

Skills

Case management

Discharge planning

Acute care experience

Education

Nursing or Social Work or healthcare concentration

Job description

Summary:

The Care Management Program Manager is responsible for the oversight and optimization of patient flow and the communication and documentation among stakeholders related to the discharge readiness and planning of the patients in the hospital. Stakeholders include, but are not limited to, the physician, nursing, ancillary team members, local hospital leadership, and the care management department. The Program Manager acts as the central point of contact for collaborating throughout the hospital in order to remove discharge barriers and to mitigate potential delays in care. The Program Manager also compiles and tracks data related to discharge barriers to evaluate the need for systemic change to workflows that result in delays in patient progression of care and monitors the effectiveness of potential solutions in an effort to manage and reduce length of stay and enhance access to care from the community. The Program Manager is responsible for education to departments within the hospital relative to throughput and medical necessity for continued hospitalization, and for process improvement and organizational development opportunities across the hospital.

Responsibilities:

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Oversees and optimizes patient flow within the hospital.
• Identifies and addresses bottlenecks helping to ensure timely transitions and discharges.
• Works with and participates in educating physicians and other clinical associates regarding clinical guidelines for medical necessity.
• Evaluates, monitors, and improves throughput via metrics as it relates to discharge planning.
• Drives length of stay reduction and optimization by identification and mitigation of discharge and throughput barriers.
• Monitors patient flow data to identify areas for improvement and implement strategies to optimize patient care delivery.
• Ensures optimal bed utilization and availability.
• Coordinates exchange of information and communication related to care needs, discharge barriers, and throughput challenges among hospitalist and other physician groups, nursing and nursing administration, Emergency Department personnel, Care Management, and other ancillary departments.
• Prepares for daily morning huddle by identifying written discharge orders and notifies appropriate teams when discharge orders are present.
• Attends daily afternoon physician rounds.
• Tracks patients in observation status and escalates to appropriate associates when an opportunity for conversion to inpatient or for discharge is identified.
• Identifies and records avoidable delays in the EMR.
• Follows established escalation protocols for delays in discharge and care delivery delays.
• Demonstrates the ability to communicate effectively, expresses ideas clearly, actively listens and follows appropriate channels of communication.
• Demonstrates clinical competency ability to collaborate with others; ability to initiate and plan own work activities.
• Participates in the strategic planning activities of the department.
• Demonstrates strong interpersonal skills, handles conflict constructively.
• Participates in interdisciplinary committees within the hospital and special projects.
• Demonstrates good judgment in problem solving, communicates unresolved problems to appropriate personnel.
• Demonstrates familiarity with evidence-based medical necessity criteria sets.
• Follows the CHRISTUS Health Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected health Information (PHI).

Job Requirements:

Education/Skills

• Education in nursing, social work, or other applicable health care concentration required

Experience

• 3 or more years of experience in case management, preferably in the acute care setting, required

Licenses, Registrations, or Certifications

• Nursing, Social Work, or other applicable healthcare field license to practice in the state of employment (or compact) required
• Certification in Case Management preferred

Work Schedule:

8AM - 5PM Monday-Friday

Work Type:

Full Time