Location: 90% remote - will be required to attend staff meetings
Schedule: Monday - Friday 8am - 5pm
The Manager Comprehensive Care Management QA manages the activities and staff responsible for assessing and coordinating patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization.
ESSENTIAL FUNCTIONS OF THE ROLE
Provides administrative, technical and clinical management of assigned staff in accordance with industry best practices which includes the responsibility for hiring, firing, performance evaluation, education, staff development, work allocation, and problem resolution.
Coordinates and supports ongoing problem solving related to care coordination, discharge planning, case management and utilization review.
Monitors processes and systems to ensure efficient delivery of services. Establishes tools, processes, and systems to optimize the case management role.
Ensures appropriate patient care needs are met and treatment plans are executed in the appropriate level of the continuum.
Develops structures, relationships, and processes to facilitate participation by physicians, pharmacists, nurses, social workers and other health professionals in multidisciplinary care planning, care delivery, and discharge planning.
Develops and implements standardized polices to achieve efficiency of operations and the provision of optimum patient care. Ensures compliance with all institutional policies and regulatory requirements.
Ensures appropriate scope of practice by staff. Ensures that subordinates are familiar with prominent ethical standards in the profession, especially related to issues such as confidentiality, informed consent, conflicts of interest, dual relationships, boundary issues, documentation, consultation, referral, and termination of services.
Develops meaningful performance measures to determine the quality, effectiveness and efficiency of operations in achieving desired outcomes.
KEY SUCCESS FACTORS
Knowledge of Care Coordination, discharge planning, case management and utilization review.
Knowledge of human behavior and performance; individual differences in ability, personality, and interests; psychosocial methods; and the assessment and treatment of behavioral and affective disorders.
Knowledge of the principles and methods to restore or enhance social, psychosocial, or bio-psychosocial functioning of individuals, couples, families, groups, organizations and communities.
Ability to develop structures, relationships, and processes to facilitate multidisciplinary care planning, care delivery, and discharge planning.
Ability to standardize policies, procedures, and programs.
Interpersonal skills to interact with a wide range of constituencies.
Verbal and written communication skills.Ability to make operational decisions around how work gets done - quality and productivity standards, measurable goals for employees and project teams, etc.
Ability to use broader objectives to determine how best to use resources to meet schedules and goals.
Ability to make or approve effective hiring and termination decisions.
Ability to evaluate and recommend changes to policies, and establish procedures that affect the managed organization.
Basic business knowledge, including but not limited to: annual planning and goal setting, adherence to budgets, employee compensation, compliance and risk management.
General computer skills, including but not limited to: Microsoft Office, information security, scheduling and payroll systems, electronic medical documentation, and email.
Our competitive benefits package includes the following - Immediate eligibility for health and welfare benefits - 401(k) savings plan with dollar-for-dollar match up to 5% - Tuition Reimbursement - PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level
- EDUCATION - Masters' or Bachelors plus 2 years of work experience above the minimum qualification
- MAJOR - Nursing or Social Work
- EXPERIENCE - 5 Years of Experience
- CERTIFICATION/LICENSE/REGISTRATION - Lic Clinical Social Worker (LCSW), Lic Masters Social Worker (LMSW), Registered Nurse (RN): Must have one of the following: LCSW - Lic Clinical Social Worker LMSW - Lic Masters Social Worker RN - Registered Nurse.
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!