Inspire health. Serve with compassion. Be the difference.

Job Summary

This position is responsible for providing overall management of the daily operations for Prisma Health Hospital Care Management. Accountable for the development of the CM/SW staffing plan and associated budgets. Collaborates with the Director, Physicians, administrative leadership and community providers to identify and act upon opportunities for process improvement across the system and within the scope of care management. Develops the Hospital Care Management program to enhance the distinction in staff roles related to progression of care, physician partnership, transitions in care, patient advocacy and fiscal responsibility.

Accountabilities

• Demonstrates a broad knowledge of clinical practice using innovative critical thinking skills.  Demonstrates expert knowledge of Hospital Care Management functions including but not limited to working knowledge of medical necessity criteria, patient management, care management documentation systems, and all other systems used in the daily care management activities. Responsible for working directly with the Director to foster development and coordination of staff education, team building initiatives and care management strategies. 20%

• Works in the clinical areas with staff to mentor, advise and support effective change in response to identified barriers. 15%

• Responsible for leading initiatives that will identify potential concerns that may cause dissatisfiers for patients, customers, and staff and developing programs that will enhance satisfaction for each of these populations. 15%

• Acts in a managerial role related to Human Resources activities  including staff management, policy and procedure development, and performance evaluations of staff.  Responsible for interviewing and hiring of staff as well as performance coaching for existing staff members. 20%

• Responsible for financial management activities for the department to include the management of applicable budget processes. 5%

• Responsible for the management of data collection initiatives that will garner quantifiable data illustrating the impact the department is having on clinical care management throughout the system.  Responsible for planning statistical audits and performing root cause analyses that will add integrity to data collected and managed by the department. 10%

• Responsible for the management and reporting of all regulatory compliance efforts with various applicable regulatory agencies. 5%

• Develop and implement policies and procedures that guide and support the provision of the services. 10%

Supervisory/Management Responsibilities

Job has direct and/or indirect supervision of employees that may include final budget authority, hire/termination/disciplinary authority, performance appraisal responsibility. Job will be considered a member of the management staff with direct reports.

Minimum Education

Bachelor's degree - Nursing

Minimum Experience

Three (3) years of acute care case management experience required.

One (1) year of lead, coordinator or supervisor experience preferred.

Two (2) years of RN experience at the bedside in an acute care setting preferred.

Required Certifications/Registrations/Licenses

Licensed to practice as a RN in South Carolina.

Other Required Experience

Medical Necessity Criteria (Interqual, MCG) knowledge and experience - required

Accredited Case Manager (ACM) or Certified Case Manager (CCM) certification- preferred

Work Shift

Day (United States of America)

Location

Roger C Peace Rehab Hosp

Facility

1010 Roger C Peace Rehabilitation Hospital

Department

10109035 Administrative and General

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.