Case Manager Specialist- 40 hrs
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POST DATE 9/7/2016
END DATE 10/29/2016
Massachusetts General Hospital(MGH)
JOB DESCRIPTIONThe Case Management Nursing Coordinator works with case managers in designated areas and is an integral part of the Case Management Department. The position reports to the respective Nurse Director of the clinical areas assigned within the Case Management department. The Case Management Nursing Coordinator is responsible for researching, organizing and maintaining case management functions related to case management orientation, safe transition planning, compliance and appropriate utilization of resources. The Nursing Coordinator serves as the liaison between case managers and Case Management Leadership and is responsible for providing day to day support with case management operations and provides insight on process improvement and problem solving.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
* Dedicates a minimum of 60% of time to activities related to Case Management and Clinical activities.
* Provides clinical oversight and support with case management daily operations. Facilitates redistribution of daily work as needed based on staffing.
* Works directly with Case Managers daily on resolution for complex discharges, identification of barriers to discharge and facilitate throughput.
* Assists Case Managers with identification of appropriate post discharge level of care determinations as necessary.
* Facilitates weekly rounds with case managers and reviews length of stay and resource management activities
* Provides additional support with case management activities if staffing is significantly impacting throughput efforts
* Serves as a resource for discharge planning and utilization review activities
* Assists Case Managers in identification of cases appropriate to escalate to the Physician Advisor
* Provides support and problem solving on patients with extensive length of stays
* Works collaboratively with the Case Managers to facilitate repatriation efforts and participates in resource allocation research
* Helps facilitate discharges during Code Help and Disaster situations
PROFESSIONAL DEVELOPMENT/CLINICAL COMPETENCY:
* Conducts ongoing observation and assessment of the CMs work to ensure compliance with standards of practice, policies and procedures to assess opportunities to enhance the case manager role.
* Coaches, demonstrates and teaches techniques that enhance skills necessary to achieve successful CM outcomes. These skills include proactive care planning, positive relationship building and effective written/verbal communication, ability to effect change, planning, organizing and critical thinking.
* Proficient in clinical operations/regulations/contracts in order to provide timely direction and support to the CM role
* Identifies best techniques to promote team building with staff
* Coordinates and supports case management orientation for new hires
* Updates and maintains orientation manuals
* Serves as an advanced clinical resource for the department
* Provides mentoring and support to novice case managers during and after orientation
* Assesses clinical skill and competence in new staff and supports educational activities and professional development activities for the department
* Develops and coordinates inservice education and external educational programs
* Develops and disseminates information that supports clinical competency
* Encourages and promotes continuing professional development including certification and clinical recognition development
* Participates in staff meeting presentations
* Maintains current knowledge in case management dept updates, payer and provider updates and policy and procedure related to case management activities
* Facilitates team based documentation auditing to assist in learning best practice.
* Consults as requested by CM Leadership with individual Case Managers on problems related to Case Management practice
* Promotes the role of the case manager in the institution or community to further patient focused transitions of care
* Supports and promotes Case Management Weeks activities
* Participates in clinical policy and procedure development
* Participates in departmental strategic planning as required
* Provides feedback for annual evaluations as it relates to Case Management Standards of Practice and documentation
* Supports/educates staff around documentation standards of practice
* Assesses and provides suggestions for enhancement and improvement in documentation practice to ensure clinical and billing compliance
* RN with current Massachusetts licensure, bachelors degree preferred
* Case management experience with advanced knowledge around standards of practice and regulatory and payer compliance
* Extensive experience and resource knowledge regarding discharge planning
* Utilization Review experience with strong criteria set understanding
Demonstrated understanding of the case management process
* Computer skills including word processing, spreadsheet, and database skills
* Strong oral and written communication skills
* Strong problem solving skills
Ability to manage multiple tasks and priorities
Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.