- Serve as a case management subject-matter expert, advisor, and leader for the case management team.
- Supervise, facilitate, and oversee staff development and daily department activities and tasks.
- Collaboratively work and maintain active communication with the primary care practitioners and other members of the care team to achieve timely, appropriate patient management.
- Effectively communicate with patients, family, medical staff, care team members, students, supervisors, and external contacts as needed.
- Monitor the quality of case management interactions with patients, families, physicians, and multidisciplinary teams by regularly shadowing staff to ensure clear understanding and adherence to department processes.
- Regularly audit case management associates' documentation to monitor quality of documentation, productivity, and assessments.
- Schedule and staff department, department education, and competencies.
- Complete daily, weekly, and monthly reports as assigned by the Director of Case Management.
- Adhere to established policies, procedures, and standards of care.
- Promptly escalate issues through established chain of command.
- Demonstrate knowledge of CMS and Medicaid requirements, quality and HEDIS initiatives, health plan processes, and compliance policies.
- Serve as an advocate for patients' rights, needs, and values; ensuring that patients' ethnic, cultural, or religious values, beliefs, preferences, and needs are considered.
- Perform other duties as assigned.
- Registered Nurse with current state licensure, BSN preferred.
- Three years of clinical, hospital nursing experience required.
- Three to five years' previous case management experience required.
- One to two years of supervisory experience preferred.
- Case Management certification desirable
- Bilingual in English and Spanish preferred.
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Manager of Case Management - Miami, United States - Miami Beach Medical Group
Description
The Manager of Case Management coordinates all aspects of clinic-based case management to promote patient-centered care, balance optimal care, and manage resource utilization.
Duties and Responsibilities: