Assistant Director of Case Management
Location
United States
Posted
7 hours ago
Salary
$75K - $90K / year
Seniority
Lead
No structured requirement data.
Job Description
Assistant Director of Case Management
Adobe Care And Wellness LLC
Role Description The Assistant Director of the RN Case Managers is responsible for a reduced number of assigned members in assessing patient/family psychosocial needs, planning, implementing, procuring services for, and evaluating care needs. Goal focus on improving quality of life and health literacy. Coordinates, monitors, and ensures that appropriate and timely primary, acute and long-term care services are provided to members across the continuum of care. Promotes effective healthcare utilization, monitors health care resources, and assumes a leadership role within the Interdisciplinary Care Team (ICT) to achieve optimal clinical and resource outcomes for members. Duties & Responsibilities - RN Case Management (Estimated 50% case load): - Evaluates members for case management services and determines appropriate level of care coordination/management services for member. - Completes a comprehensive assessment and develops a care plan utilizing clinical expertise to evaluate the members need for alternative services. - Acts as a primary case manager for members identified as Complex as defined by Case Management Program Description. - Acts as a primary case manager for all assigned SNP members. - Develops and monitors members plan of care, to include progress toward meeting established goals and self-management activities. - Interacts continuously with member, family, physician(s), and other providers utilizing clinical knowledge and expertise to determine medical history and status. - Assesses the options for care including use of benefits and community resources to update the care plan. - Supervises and/or acts as a resource for staff (i.e., Care navigators and LPN case managers). - Acts as liaison and member advocate between the member/family, physician and facilities/agencies. - Maintains accurate records of case management activities in the EMR using clinical guidelines. - Coordinates community resources, with emphasis on medical, behavioral, and social services. - Applies case management standards, maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality-of-care issues. - Ensures compliance with all state and federal regulations as well as corporate guidelines in day-to-day activities. - Meets with clients in their homes, physician’s offices, or hospitals to provide management of services. - Adapts to changes in policies, procedures, new techniques, and additional responsibilities. - Participates with other Case Managers and Medical Directors in regular or special meetings such as Clinical rounds. - Management of RN Case Managers: - Coordinates the on-boarding process for all new RN Case Managers to include scheduling of orientation, development of training schedule, coordination of other RN Case Managers to assist with orientation (prn), maintaining new hire training materials, and collaboration with Director on post training follow up. - Provide information and assistance for NPI application. - Collaborate with Director on work process development and roll out to RN CM team. - Collaborate with Director for ICT coordination and oversight prn. - Provide ongoing training updates based on identified needs of RN CM team. - Collaborate on yearly RN CM performance evaluations. - Additional Responsibilities: - Assisting in the recruitment, orientation, training, and development of staff. - Supervises and evaluates the work of employees. - Handling other related functions as necessary. - Compliance with all HIPAA regulations. - Travel to inpatient bedside, member’s home, provider’s office, hospitals, etc. - Performs other related duties as assigned by management. Qualifications - A minimum of 2 years of experience in healthcare quality management, compliance, or a similar case management role. - In-depth knowledge of healthcare regulations, accreditation standards, and quality improvement methodologies. - Directly supervises 15+ RN Case Managers within the Case Management department. - Works collaboratively with other ADCM and DCM to meet and exceed departmental goals. - Computer skills required: Microsoft Office Suite. Education, Licenses, & Certification - Bachelor’s degree in Healthcare Administration, Nursing, Medicine, or a related field required. - Master’s degree in Healthcare Administration, Nursing, Medicine, or a related field preferred. - Current Arizona Nursing License. - Certified Case Manager (CCM) certification required within 2 years of hire. Benefits - Paid Onboarding and Training - Insurance – Medical, Dental, Vision, and Life - 401k Plan – 3% match - Employee Assistance Program - Tuition Reimbursement - Continued Education Support - Mileage Reimbursement (if applicable) - Referral Bonuses - Paid Holidays (9 days) - Paid Time Off (15 days) - Paid Volunteer Hours Character & Competencies - Courage – To have the courage to do the right thing at the right time. - Ownership – To take ownership of every issue you touch. - Respect – To respect yourself, co-workers, and those whom you care. - Excellence – To be excellent in all that you do. - Diversity – Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce. - Ethics – Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values. - Adaptability – Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. - Customer Service – Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Meets commitments. - Interpersonal Skills – Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control. - Judgement – Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions. - Problem-Solving – Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions. - Professionalism – Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration. - Teamwork – Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback. Physical Demands & Work Environment - Occasionally required to travel to meet with members or providers. - Occasionally required to stand. - Occasionally required to walk. - Continually required to sit. - Occasionally required to climb, balance, bend, stoop, kneel, or crawl. - Continually required to talk or hear. - May occasionally lift and/or move more than 30 pounds. Equal Employment Opportunity APH is an Equal Opportunity Employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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