Care Management Manager

Care Management Manager

Join Cleveland Clinics Fairview Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. Fairview Hospital has been recognized as one of the top hospitals in Cleveland and Ohio. Here, you will work with and learn from some of our best caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

As a Care Management Manager, you will supervise Care Managers, Clinical Referral Coordinators, Nurse Reviewers, Social Workers, administrative caregivers and clerical support caregivers as well as the day-to-day operations of the department.

A caregiver in this position works 7:30am – 4:30pm.

A caregiver who excels in this role will:

Utilize clinical expertise and an understanding of utilization review requirements, discharge planning process and Medicare regulations.

Contribute to the goals of cost containment and quality care.

Provide safe and appropriate discharge plans and minimize avoidable commercial payer denials.

Assist with hiring, orienting, evaluating and supervising the performance of the care management and social work caregivers.

Arrange schedules, evaluate caseloads and make daily assignments.

Evaluate and address educational needs of caregivers, conduct performance improvement management, issue corrective action as needed and ensure consistent applications of policies and compliance.

Provide input into the department budget, policies and procedures.

Assist in the development of department practices and procedures for utilization review and discharge planning, ensuring compliance with managed care contracts and Medicare regulations.

Analyze productivity and other outcome measures to identify opportunities for continuous improvement.

Manage information systems to maximize the efficiency of discharge planning.

Develop and monitor routine data quality validation.

Act as liaison with other review-related and discharge planning related functions and communicate with departments as necessary to ensure coordination of related processes and functions.

Establish relationships with post-acute care providers.

Serve as a clinical subject matter expert for teams lead by other disciplines.

Minimum qualifications for the ideal future caregiver include:

Candidate must meet either the Nursing or Social Work education requirements. Registered Nurse: Bachelor of Science in Nursing (BSN) or Bachelors in related field required. Current and valid license to practice as a Registered Nurse(RN) in the State of Ohio. Masters degree in nursing or related field preferred.

Social Work: Masters degree in Social Work accredited by the Council on Social Work Education. Current Ohio Licensed Social Worker (LSW).

Three years of experience in utilization management, case management, or discharge planning.

Three years of clinical experience.

Preferred qualifications for the ideal future caregiver include:

Professional certification as a Case Manager (CCM) preferred but will be required within one year of eligibility.

Three years of experience in a hospital/health care setting, including experience with data collection and performance improvement activities.

Supervisory experience in care management or social work.

Knowledge of processes and workflows in an inpatient acute care setting.

Ability to review and analyze data to support business operations and change management.

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how were dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/

Physical Requirements:

Requires the ability to sit and be stationary for prolonged periods of time, normal or corrected vision and manual dexterity sufficient to perform work on a personal computer.

Requires the ability to walk to various locations throughout the Clinic and facilities.

Light Work – Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects.

Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible.

Note: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.

Personal Protective Equipment:

Follows standard precautions using personal protective equipment as required.

Salaries [which may be] shown on independent job search websites reflect various market averages and do not represent information obtained directly from The Cleveland Clinic. Because we value each individual candidate, we invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process.

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities