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Job Objective: A brief overview of the position.
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The position is responsible and accountable for the operations of the Case Management Department at Eisenhower Medical Center. The manager is responsible for ensuring that utilization of resources including medical services, length of stay and appropriate status class. The manager will help promote and facilitate patient through-put within the facility and through the continuum of care. The manager will develop and oversee compliance by implementing standardized processes and procedures. The goal of the department is to provide Coordinated Care Management services to all patients’ utilizing a cost effective process that meets the needs of the individual patient.
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Reports to
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Director of Case Management
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Supervises
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Case Managers, Case Management Assistants, Administrative support personnel.
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Ages of Patients
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None
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Blood Borne Pathogens
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Minimal/ No Potential
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Qualifications
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Education
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Required: BSN
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Preferred: MSN or MBA
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Licensure/Certification
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Required: CA RN License
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Experience
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Required: Five (5 ) years of experience in Case Management with two (2) years of experience in Acute Hospital Case Management
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Preferred: Previous managerial experience and Case Management Certification
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Essential Responsibilities
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Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
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Ensures compliance with regulatory requirements and with policies and procedures.
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Maintains knowledge of and compliance with laws, regulations (federal and state) as well as JC accreditation standards and contractual agreements pertaining to Case Management.
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Ensures efficiency, productivity and sufficient financial resources during budget process.
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Monitors quality and outcome data and in development and implementation of plans to meet department and organizational goals and service standards.
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Collaborate and coordinate with the Quality Improvement Department, Decision Support, Medical Staff Services, and other departments in the completion of focused studies, as requested, for Case Management related issues.
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Develop and implement corrective action plans proactively when process and other issues
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Oversee the daily coordination efforts between physicians, nurses, and other healthcare professionals to facilitate timely patient care transitions and overall workflow.
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Ensure that patient care plans are effectively communicated and executed.
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Manage daily resource allocation and bed utilization, making real-time adjustments to optimize patient flow.
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Collaborate with the bed management team to ensure efficient patient placement within the hospital.
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Advocate for the best interests of patients and address any immediate barriers to their care and transition.
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Foster daily collaboration with clinical and administrative teams to resolve issues, streamline processes, and address challenges affecting patient care and throughput.
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Participate in daily case conferences to address complex cases and expedite care decisions.
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Oversee the Observation and Traditional Medicare utilization review process on a daily basis to ensure real-time compliance with regulatory and accreditation standards.
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Collaborate with Utilization Review Team regarding any patient authorization concerns and need for discharge planning information.
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Monitor and address documentation issues as they arise.
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Ensure prompt decision-making to optimize resource utilization.
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Collect and analyze daily utilization data to identify immediate trends and variations.
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Lead, staff, manage, and mentor the care coordination team, providing real-time guidance and support to maintain a high level of performance.
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Identify and address immediate training needs and provide daily education to the care coordination team to ensure they are equipped with the latest best practices.
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Foster a culture of continuous improvement and excellence on a daily basis.
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Monitor daily patient feedback and satisfaction related to the care transition process.
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Implement quick strategies to enhance the daily patient experience.
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A commitment to fostering a culture of team building, integrity, and compassion.
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Expected to actively participate in representing and promoting Eisenhower Health in the community. This includes engaging in community outreach, partnerships, and initiatives that enhance the organization’s presence and reputation in the local area.
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May involve direct care coordination, utilization review or other duties dependent on the needs of the department.
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May involve occasional evening or weekend work to address immediate patient care and transition needs.
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Other duties as assigned.
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Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California.
