Your time at work should be fulfilling. Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities. Imagine your career at Catholic Health Initiatives!
Works collaboratively with physicians, staff and other health care professionals within the Division to coordinate the care and service of selected patient populations across the continuum. The role performs supervisory duties over care management staff and activities. The role works collaboratively with patient, family, physician and other members of the health care team to achieve the highest quality clinical outcomes with the most cost effective use of available resources. The role provides training and technical support, monitoring caseloads for accuracy in the application of program rules and regulations, and identifying areas for process improvement in order to support the care management team. The role serves as a liaison to internal and external stakeholders in order to maintain and improve collaborative relationships, exchange information, and resolve problem areas; and recommends process improvements. The Manager of Care Management is an integral member of the health care team. In addition the position collaborates with the Divisional Care Management team on system-wide quality improvement/performance improvement initiatives.
Essential Key Job Responsibilities
Has the authority to interview, hire, orient, terminate, promote, train, and conduct performance evaluations.
Assigns day-to-day work activities; directs the functional and technical job performance of team members.
Allocates and directs staffing needs to meet patient, unit, and department needs, and collaborates with others to ensure overall staffing needs are met.
Manage performance including: Setting goals, clarifying job expectations, monitoring performance progress, providing feedback and recognition, developing skills and addressing performance issues related to our work and our Commitments using corrective action.
Understands and self-manages to support organization success goals, including improvements in quality, cost of care and member experience for the population served.
Identifies opportunities for improvement (at individual, clinic, facility and CIN levels) and actively works with healthcare team to correct or improve results.
Responsible for the financial budget of the department. Evaluates current staffing utilizing approved staffing ratios and submits requests for additional staff as it relates to the staffing model.
Stays current, audits, educates and trains on regulatory and reimbursement issues.
Reviews, develops, or modifies work plans, methods, and procedures, determines work priorities, and develops work schedules to provide adequate staff coverage.
Leads and participates in activities to ensure successful development, implementation and monitoring of all strategic initiatives for Care Management.
Assists with the analysis of denied days, denial report preparation and trending of denial data and physician performance.
Serves as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation.
Bachelor’s Degree required.
Registered Nurse Licensure or Licensed as Social Worker Required.
Must have at least 3 years leadership experience
About CHI Health
CHI Health is a regional health network with a unified mission: nurturing the healing ministry of the Church while creating healthier communities. Headquartered in Omaha, the combined organization consists of 15 hospitals, two stand-alone behavioral health facilities and more than 150 employed physician practice locations in Nebraska and southwestern Iowa. More than 12,000 employees comprise the workforce of this network that includes 2,820 licensed beds and serves as the primary teaching partner of Creighton University’s health sciences schools. In fiscal year 2014, the organization provided a combined $149.3 million in quantified community benefit including services for the poor, free clinics, education and research. With locations stretching from Kearney, Neb. to Missouri Valley, Iowa, the health network is the largest in Nebraska and serves residents of Nebraska and southwest Iowa. For more information, visit online at CHIhealth.com.