Case Management Manager Position Available In Washington, Pennsylvania

Case Management Manager 3.4 3.4 out of 5 stars 155 Wilson Avenue, Washington, PA 15301 Case Management Manager•

UPMC Washington Job ID:

6620257955

Status:

Full-Time Regular/Temporary:

Regular Shift:

Day Job Facility:

UPMC Washington Department:

Case Management Location:

155

Wilson Avenue, Washington, PA Union Position:

No Salary Range:

$ 49.2-68.8 USD The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the following Case Management functions: training, auditing, systems support: Case Management Technology, InterQual, Concurrent Denials and reporting. Leads efforts to develop, implement, evaluate, redesign and modify Case Management practice standards. Works closely with the Case Management staff in an effort to safely, effectively and efficiently move patients across and through the continuum of care.

Responsibilities:

Develops reporting tools to assist Director and executive leadership teams to assess the effectiveness of Case Management efforts. Collaborates with other UPMC departments to establish mechanisms to address issues related to care management, tracks, trends avoidable day/delay documentation and reports to Director trends/barriers. Analyzes data for trends related to variation in actual vs. targeted length of stay. Collaborates with other staff to develop performance improvement activities as indicated. Oversees daily operations of the Case Manager (CM) staff under the direction of the Director. Conducts employee performance reviews. Utilizes identified denial trends to develop training tools to facilitate maximum financial reimbursement. Monitors and mentors Case Management staff. Develops and implements processes for timely and accurate documentation of appropriate data relating to concurrent denials. Collaborates with other departments to generate outcome data as needed to measure and trend performance indicators. Coordinates with Case Management in an effort to meet the established length of stay targets. Coordinates with Case Management staff to ensure safe/effective/efficient plans of care are implemented Conducts inter rater reliability audits per established policy. Ensures training programs address identified needs of Case Management staff Assists with management of departmental budget. Collaborates with Director, Medical Director/Physician Advisor and staff to ensure effective processes and systems are established and maintained to meet department goals. Participates in leadership development. Functions as a resource person for the care management and denial management processes. Coordinates daily flow of the department (this includes overseeing PTO requests, assignment coverage, weekend coverage) Takes a leadership role in the mentoring and monitoring of documentation expectations in Case Management technology. Analyzes data for trends and causative factors that promote or impede progression toward positive care management outcomes.

Qualifications:

MSN/MS in related field OR enrolled within 1 year of hire & complete within 3 years of enrollment 3 YOE required; 3 YOE in Care Management, 1 YOE in leadership

Licensure, Certifications, and Clearances:

Current licensure as a Registered Nurse in practicing state required. UPMC approved Care Management certification or agreement to obtain upon hire required.

Behavioral Dimensions:

1. Current knowledge of medical care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization/case management, discharge planning, Medicare, Medicaid, and other third party payor requirements, and managed care principles preferred.2. Use of expert clinical practice, leadership skills, and critical thinking skills to efficiently coordinate and direct patient care among all health care providers while maximizing use of resources is required.3. The ability to prepare and critically analyze data, make appropriate recommendations toward resolution, and follow-through of identified action is required.4. Expertise in interpersonal relationships, organizational relations, and effective communication, negotiation, and conflict resolution skills are required.5. The motivation and drive to work independently with minimal supervision to pursue continuous development of self and others are required.6. Strong sense of commitment and of being in control of ones practice is needed. Ability to effectively resolve practice issues and facilitates practice changes within the organization and throughout the continuum of care is required.7. Ability to foster principles of participative management by identifying/involving relevant individuals in program-related decisions is required.8. Ability to apply creative and innovative approaches to develop and maintain systems that achieve higher levels of multi-disciplinary team performance and desired patient outcomes is needed. Registered Nurse (RN) Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state. UPMC is an Equal Opportunity Employer/Disability/Veteran Why Work Here We know that you have many options when choosing where to build your career. So why choose UPMC? We can think of a few reasons. Work-Life Balance Finding the ideal balance to manage the important elements in your life. Development & Opportunities Enhancing your career through continued learning opportunities and/or advancement. Compensation Receiving competitive pay for the work that you do

• base pay, merit, and premium pay.

Performance & Recognition Rewarding performance that supports the goals and mission of UPMC. Benefits Providing assistance and security to meet the current and future needs of you and your family. Work-Life Balance Finding the ideal balance to manage the important elements in your life. Development & Opportunities Enhancing your career through continued learning opportunities and/or advancement. Compensation Receiving competitive pay for the work that you do

• base pay, merit, and premium pay.

Performance & Recognition Rewarding performance that supports the goals and mission of UPMC. Benefits Providing assistance and security to meet the current and future needs of you and your family. Benefits that Matter to You We’re committed to providing benefits that meet your needs and support your well-being in all areas of life. Earn over 5 weeks of paid time off every year Affordable medical, dental & vision coverage Student loan assistance and tuition reimbursement options Earn up to 8% of your eligible pay in retirement contributions from UPMC Employer-paid life insurance Benefits that Matter to You We’re committed to providing benefits that meet your needs and support your well-being in all areas of life. Earn over 5 weeks of paid time off every year Affordable medical, dental & vision coverage Student loan assistance and tuition reimbursement options Earn up to 8% of your eligible pay in retirement contributions from UPMC Employer-paid life insurance Benefits that Matter to You We’re committed to providing our employees with benefits that meet their needs and support their well-being in all areas of life. Earn over 5 weeks of paid time off every year Affordable medical, dental & vision coverage Student loan assistance and tuition reimbursement options Earn up to 8% of your eligible pay in retirement contributions from UPMC Employer-paid life insurance Support for You

• and Your Family Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family. Two weeks of paid parental leave Family planning resources Tuition assistance for dependents Comprehensive health care for dependents Emergency child and elder care options Flexible work arrangements Support for You
• and Your Family Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family. Two weeks of paid parental leave Family planning resources Tuition assistance for dependents Comprehensive health care for dependents Emergency child and elder care options Flexible work arrangements Support for You
• and Your Family Your career doesn’t impact just you, but the people you care about, too.

We’re making sure your career works for the whole family. Flexibility to choose the shifts and work arrangements work best for your lifestyle Two weeks of paid parental leave Family planning resources Comprehensive health care for dependents Emergency child and elder care options A Culture That Cares At UPMC, you can find a home among people who share your passions and care about who you are. Employee resource groups Awards for champions of dignity & respect Center for Workplace Culture and Engagement Programs for veteran engagement A Culture That Cares At UPMC, you can find a home among people who share your passions and care about who you are. Employee resource groups Awards for champions of dignity & respect Center for Workplace Culture and Engagement Programs for veteran engagement A Culture That Cares UPMC is a place where you can find a home, no matter your gender, race, sexual orientation, age, or culture, and where you can meet people who share your passions and care about you. Employee resource groups Awards for champions of dignity & respect Center for Workplace Culture and Engagement Programs for Veteran Engagement Tools to Reach Your Potential Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams. Up to $6,000 of annual tuition assistance Ongoing learning via LinkedIn Learning Accelerated career pathways for growth Robust instructor-led education and learning pathways Tools to Reach Your Potential Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams. Up to $6,000 of annual tuition assistance Ongoing learning via LinkedIn Learning Accelerated career pathways for growth Robust instructor-led education and learning pathways Tools to Reach Your Potential Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams. Unlimited educational possibilities, including no-cost BSN and MSN programs Robust career ladders for every nurse

• no matter your specialty, location, or career stage Up to $6,000 of annual tuition assistance Ongoing learning opportunities Expansive Opportunity Where do you want to go with your career?

Wherever it is, UPMC can take you there. 100,000 employees 40+ hospitals and 800+ doctors’ offices and outpatient sites Dozens of career ladders to climb International locations State-of-the-art technology Expansive Opportunity Where do you want to go with your career? Wherever it is, UPMC can take you there. 100,000 employees 40+ hospitals and 800+ doctors’ offices and outpatient sites Dozens of career ladders to climb International locations State-of-the-art technology Expansive Opportunity Where do you want to go with your career? Wherever it is, UPMC can take you there. 100,000 employees 40+ hospitals and 800+ doctors’ offices and outpatient sites International locations State of-the-art technology