Manager | Case Management - University | FT - Days Job

Summary

The Manager Case Management is responsible for the daily activities and responsibilities of the assigned case management team.  Works collaboratively with all areas of MLH staff in the development, implementation, and support of program development.  Assists with the communication of performance metrics and compliance with performance standards. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

Knowledge/Skills/Abilities

• Demonstrated ability to consistently exercise sound judgement and initiative in all circumstances, including very stressful situations.
• Thorough knowledge of health benefit and the administrative services performed in the processing of health benefit claims.
• Knowledge, skill and proficiency in the development, implementation and operation of various alternative delivery systems and understanding of relationship of the provider, purchaser and payer in such a system.
• Thorough understanding of the coding and classification systems used for medical records and medical services billing including the classification of diseases and clinical procedural terminology.
• Excellent written and verbal communication skills.
• General PC skills and knowledge of Case Management/ Utilization Management software packages.
• Ability to deal effectively and efficiently with physicians, patients and associates.
• Ability to establish and maintain working relationships with co-workers, other department and other areas.
• Ability to prepare and deliver presentations to summarize project or assignment progress and results.
• Ability to set priorities, coordinate multiple tasks, and maintain controls of workflow.

Key Job Responsibilities

• Manages the daily operations of the assigned case management team to meet department objectives of determining medical necessity of admissions, coordination of appropriate plans of care, discharge planning, documentation, referrals, and care facilitation.
• Participates in hiring, development, and maintenance of a competent, productive and quality conscious staff.
• Understands, applies, and supports department and hospital policies, procedures and standards.
• Demonstrates effective customer relations skills, promotes a positive work environment and contributes to the overall team effort.  Establishes good working relationships with physicians, clients and other members of the health care team.
• Actively participates in and promotes Methodist Le Bonheur Healthcare’s commitment to Quality Improvement efforts; identifies and communicates areas for improvement in ongoing efforts for quality care; assists in gathering, analyzing and presenting data as assigned.

Physical Requirements

• The physical activities of this position may include climbing, pushing , standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light-work-exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.
• The Associate is required to travel locally, must provide own transportation.
• The Associate is required to have visual acuity to operate motor vehicles.