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Manager Care Management

Houston, TX, United States

Overview

Baylor St. Luke’s Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in cardiovascular care neuroscience oncology transplantation and more. Our team’s efforts have led to the creation of many research programs and initiatives to develop advanced treatments found nowhere else in the world. In our commitment to advancing standards in an ever-evolving healthcare environment our new McNair Campus is designed around the human experience—modeled on evidence-based practices for the safety of patients visitors staff and physicians. The 27.5-acre campus represents the future of healthcare through a transformative alliance focused on leading-edge patient care research and education. Our strong alliance with Texas Heart Institute and Baylor College of Medicine allows us to bring our patients a powerful network of care unlike any other. Our collaboration is focused on increasing access to care through a growing network of leading specialists and revolutionizing healthcare to save lives and improve the health of the communities we serve.

The Manager of Care Management is responsible for the daily oversight of the daily operations and coordination for designated units related to the activitiesassigned to Case Management staff including daily team operations, internal and external departmental relations, and recruitment/evaluation of staff. This includes both internal and external case managers in order to meet regulatory guidelines and maintain or obtain Manage Care contracts. Proactively Develops and promotes methodologies that effect staff productivity. Serves as the subject matter expert for case management Functions and regulatory compliance for the director and department members.

* Registered Nurse (RN) is required for this position

Responsibilities

1. Facilitates staff

a. Provides leadership, direction and coordination of assignments for staff.

b. Assesses daily staffing needs and Provides staffing resources to ensure efficient and effective coordination of services.

c. Responsible for performance appraisals, corrective action for team members.

2. Clinical Management

a. Serves as a clinical resource for utilization management, compliance for the rules and regulations for government, non‐government payers and regulatory agencies.

b. Collaborates with he medical staff, nursing staff, patient, family, decision maker(s), other disciplines int he coordination of the plan of care.

c. Use of critical thinking skills in the development of care plans.

3. Monitoring of departmental goals

a. Collaborates with Director and staff to implement, monitor and review enhance plans to achieve established for the department.

b. Reviews reports applicable to CIC and responds with an appropriate action plan.

c. Reviews work assignments and projects of the department staff to ensure departmental goals are achieved.

4. Outcomes Management

a. Participates in the development, implementation, evaluation of policies and procedures.

b. Assesses data and implementation of process(as) improvement initiatives as needed.

5. Professional Development

a. Initiates and Participates in activities to enhance professional development.

b. Serves as a resource to staff by providing coaching in order to promote staff member accountability and responsibility.

Qualifications

Required Education and Experience

*Bachelor’s Degree

*Registered Nurse (RN)

*Five (5) years leadership experience

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Manager Care Management jobs in Houston, TX, United States

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