Manager Care Management

Qualifications:

Required:

• Current license in the state of practice as a registered nurse or social worker
• Bachelor’s degree in nursing from accredited educational institution, or actively pursuing degree and to be obtained within five years of accepting position, bachelor’s in health care or business administration or master’s social work (MSW)

·         Four years of acute RN/SW case management experience in an acute healthcare facility

·         American Case Management Certification (ACM) or obtain certification when eligible as defined by the Association Case Management Association, and maintenance of continuing education requirements.

·         Member of the American Case Management Association (ACMA)

Preferred: 

• Master's degree in business or a health-related field
• Two years of experience in supervision

·         Experience in social work, utilization review, clinical documentation, critical care, or quality.

• Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training Network (MTN)

Knowledge, Skills, and Abilities:

1.      Ability to travel to various hospitals and locations, including patient care areas, conference facilities, System offices and other sites as requested.

2. Ability to work independently and provide sound judgement in interactions with the interdisciplinary team, patients, families, and payers.

3.      Ability to work with diverse teams and individuals, team player

4. Able to spend majority of time utilizing a computer, monitor, keyboard and mouse; ability to type.
5. Adaptability, strong critical thinking skills, creative problem-solving skills, and ability to collaborate.
6. Comfortable operating independently in a collaborative, shared leadership environment.
7. Compliance with the Nursing Code of Ethics and Guide for Professional Conduct
8. Customer-focused attitude and ability to work proactively and efficiently with appropriate urgency.

9.      Demonstrated leadership skills such as accountability, professionalism, decision-making, coaching, counseling, conflict resolution, discretion, diplomacy and tact.

10. Prioritization and organizational skills required. Ability to educate all members of the healthcare team related to care management.
11. Strong knowledge and skills working with computerized hospital/health information management systems and software applications (i.e. Cerner, Paragon, Meditech, InterQual, etc.) and Microsoft Suite applications.
12. High degree of interpersonal skills with ability to effectively communicate with physicians, nursing, families/patients, utilization management and internal and external customers. 
13. Knowledge of care management standards of excellence and best practice.

14.  Maintains knowledge of applicable national care management standards, CMS rules and billing regulations related to Medicare, Medicaid, and commercial insurance

15. Possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of McLaren Health Care.
16. Project management and organization abilities necessary to work with an interdisciplinary team in identifying sources of data for efficient clinical, functional, service and cost outcome studies, and to work with a team of support personnel from multiple departments.
17. Strong analytical ability to gather and interpret data to identify discrepancies, problems or issues, to determine compliance with regulations, policies and procedures and to apply sound judgment.

18.  Weekend, holiday, and evening coverage as per site requirements