Supervisor, CARE Management and Social Services
Responsible to Trumbull Regional Medical Center (TRMC) for supporting the corporate mission, vision and values. Responsible to Care Management and Social Services at TRMC to utilize an interdisciplinary approach to managing patient throughput in a clinically and fiscally responsible manner to achieve optimal outcomes. The Supervisor Care Management is responsible for assisting with all the daily operations of the Care Management Department including Case Managers, Social Workers and Administrative Assistant. The Supervisor Care Management/Social Services assists the Department Director in employee supervision, management, and training; data research and analysis; development and implementation of quality initiatives designed to support defined objectives. Guides team in resource management. Maintains the standard for a collaborative process of assessment, planning, facilitation and advocacy for patients in our care. Individualizes services to meets patient's health care needs by utilizing available resources to promote quality outcomes. The Supervisor Care Management/Social Services will act in the role of a staff Case Manager, or Discharge Planner when needed. Must have the ability to work competently with computer-based charting and other clinical and non-clinical software programs. Adaptability to change and good organizational skills required. Ability to read and communicate effectively in English. Can be expected to do presentations as directed. Working knowledge of criteria for Medicare, Medicaid, HMO, and private insurance carrier’s coverage details. Ability to advocate for patients. Ability to operate office equipment. Possess critical thinking skills. Leadership skills required for role include effective mentoring, coaching, counseling, time management, problem solving, and strategic planning. Demonstrates initiative and pro-active approach to problem resolution. Ability to effectively interact with insurance companies and community healthcare recourses. Ability to work in a stressful, fast paced environment. Must master Microsoft Office Products, i.e. Excel, Word etc. Understand CMI, patient status, InterQual Criteria, Milliman Criteria, and Transfer DRGs.
AND MAJOR DUTIES
- Assists Director with the daily operations of the Care Management Department.
- Gives directions to staff for referrals to Transitional Care services for patients frequently readmitted. Collaborates with Transitional Care leadership to review data trends/outcomes. Assist in Readmission Task Force.
- Assists in daily reporting of Observation, length of stay and outliers.
- Serves as a resource to staff seeking assistance, guidance, and information from the Care Management Department
- Able to communicate with physicians and the interdisciplinary team regarding complex discharge planning needs of the patient.
- Interacts professionally with patient/family and involves patient/family in the formation of the discharge plans. Is knowledgeable of patient's financial status, diagnosis, and discharge needs
- Performs other duties as assigned and appropriate
EDUCATION AND EXPERIENCE
Registered Nurse with case management experience in acute care hospital setting required. Associates degree in nursing required, bachelor’s degree in nursing preferred. Three to five years’ experience in clinical Hospital setting with progressive management responsibility and demonstrated knowledge in all aspects of care management, outcomes management, discharge planning position involving care management, utilization review responsibility in acute care hospital and/or managed care setting required. Must possess a thorough working knowledge of Medicare, Medicaid and managed care utilization review requirements. Must be familiar with federal and state accreditation standards as they relate to care management and utilization review.
LICENSURE, REGISTRATION AND/OR CERTIFICATION
Current Ohio license as a registered nurse by the Board of Nursing in good standing is required. Certification in case management is strongly preferred.