Apply on Employer Site

Munson Healthcare · 1 day ago

Patient Care Manager - Full Time Day Shift (32/Week) - Traverse City, MI

Traverse City, MI

Full-time

Onsite

Mid, Senior Level

3+ years exp

Munson Healthcare is a healthcare provider in Traverse City, MI, seeking a Patient Care Manager. The role involves facilitating patient care progression, ensuring high-quality and efficient services, and requires strong communication and leadership skills.

Hospital & Health Care

Responsibilities

Supports the Mission, Vision and Values of Munson Healthcare

Embraces and supports the Performance Improvement philosophy of Munson Healthcare

Promotes personal and patient safety

Has basic understanding of Relationship-Based Care (RBC) principles, meets expectations outlined in Commitment To My Co-workers, and supports RBC unit action plans

Uses effective customer service/interpersonal skills at all times

Maintains working knowledge/experience in utilization management, managed care, and payer issues that may impact the course of care

Timely response to screening referrals for case management services

Ability to identify appropriate community resources on assigned caseload and to work collaboratively with patients, families, and multidisciplinary team and community agencies to achieve desired patient outcomes

Confirm admission diagnosis and identify related quality/care metrics to promote medical compliance

Advocate for patient by assessing that patients healthcare needs are being addressed in the most appropriate level of care

Encourages and facilitates patient/family participation in all care and treatment decisions

Educates members of the patient’s healthcare team on the appropriate access to, and use of various levels of care

Identifies patients at risk for readmission and refers them for community based follow up

Recognizes and responds appropriately to readmission or psychosocial risk factors

Consults with physician advisor as necessary to resolve progression-of-care barriers through appropriate administrative and medical channels

Serves as primary liaison between and among physicians, patients, families, payers, external case managers and interdisciplinary clinical team

Participates in discharge planning activities for complex patients, in order to ensure a timely discharge and to provide appropriate linkage with post-discharge care providers. Refers appropriate cases to the Complex Discharge planner

Collaborates with Post-Acute Coordinators to monitor and facilitate the progress of completing complex post-acute services

Interface with utilization review specialists to stay current on patient’s eligibility for admission, continuing stay or readiness for discharge according to medical necessity guidelines. ( InterQual® criteria)

Persevere in attempts to influence clinical and financial outcomes of care

Identify and record episodes of preventable delays or avoidable days due to failure of progression-of-care processes

Participates in quality improvement plan activities and any other departmental research or studies as requested by the department manager

Assertively manage resource utilization while appropriately navigating the patient's movement along the continuum of care

Collaborate with social workers, counselors and Resource Center coordinators to research discharge placement options, when home discharge is not possible, while continuing to focus on patient/family goals, interdisciplinary team recommendations, available payer benefits and private financial considerations which may impact placement

Utilizes the Program Manager, Director and Medical Advisor as expert advisors to gain insights in dealing with physicians and Resource Management issues

Works with resource center and providers to determine patient’s eligibility for post-acute services

May assist in training and orientation of new department employees and students

Performs other duties and responsibilities as assigned

Qualification

Certified Case Manager (CCM)Bachelor’s degree in NursingHospital patient care experienceCommunication skillsOrganizational skillsProblem solving skillsAssessment skillsInterpersonal skillsLeadership skillsNegotiation skillsTime management

Required

A Bachelor's degree in Nursing or Social Work. Comparable experience will be considered in lieu of a Bachelor's degree in nursing (must have RN license or social work license)

If Registered Nurse, must be licensed to practice in Michigan. Also, for those hired into this job after January 1, 2015, it is required to obtain a BSN within 5 years of start date

If Social Worker, MSW preferred

Must have recent hospital patient care experience (minimum 3 years) and knowledge of hospital operations

Strong interview, assessment, organizational and problem solving skills and ability to work independently

Knowledge of Case Management Society of America's case management standards of practice

Eligible to sit for, and successfully pass, the test for certification as a Certified Case Manager (CCM) or Accredited Case Manager (ACM) within 2 years of employment

Demonstrates priority setting and time management capabilities

Possesses excellent communication and negotiation skills

Must demonstrate patience and tact when working with patients, families and members of the healthcare team

Fosters positive internal and external customer relations