Manager, Case Management & Social Services

Job Description

Time Type: Full time

Hours per Pay Period: 80

Shift: Day Shift

Minimum: Depending on Experience

Maximum: Depending on Experience(This represents the rate for an individual with significant experience in this job in a full-time 40 hour per week position)

Department: Case Management

Current Bay Area Hospital Employee: If you are a current Bay Area Hospital employee, please apply through the Workday internal career site.

The future looks bright at Bay Area Hospital, and we are always searching for quality people to join our team. We offer a great atmosphere, competitive pay, a wide array of benefits, and many growth opportunities for our employees.

Job Description:

• Manager Case Management & Social Services

Time Type:

• Full time

Hours per Pay Period:

• 80

Shift:

• Day Shift

Minimum:

• Depending on Experience

Maximum:

• Depending on Experience(This represents the rate for an individual with significant experience in this job in a full-time 40 hour per week position)

Department:

• Case Management

Current Bay Area Hospital Employee:

• If you are a current Bay Area Hospital employee, please apply through the Workday internal career site.

The future looks bright at Bay Area Hospital, and we are always searching for quality people to join our team. We offer a great atmosphere, competitive pay, a wide array of benefits, and many growth opportunities for our employees.

EXPECTATION FOR ALL EMPLOYEES

• Support the organization's mission, vision and values by adhering to the behavioral standards of Bay Area Hospital. Comply with all laws and regulations affecting Bay Area Hospital. Be familiar with and adhere to the Bay Area Hospital Code of Conduct and Compliance Program. Effective communication skills and the ability to work effectively with people from various backgrounds are critical.

POSITION SUMMARY The Manager of Case Management & Social Services provides operational and clinical leadership for Case Management, Social Services, discharge planning, utilization management, transitions of care, and related care coordination activities.

The Manager is responsible for ensuring effective, patient-centered care coordination across the continuum while supporting safe and timely transitions of care, appropriate utilization of healthcare resources, regulatory and payer compliance, and achievement of organizational quality, financial, and patient experience goals.

This position leads an interdisciplinary team responsible for identifying and addressing barriers to care and discharge, coordinating complex patient needs, supporting appropriate level-of-care determinations, and connecting patients and families with appropriate healthcare and community resources.

The Manager collaborates closely with physicians, nursing leadership, Quality, Revenue Cycle, Compliance, Risk Management, community providers, post-acute care organizations, and other members of the healthcare team to improve patient outcomes and facilitate efficient movement of patients through the continuum of care.

PRINCIPLE DUTIES AND RESPONSIBILITIES

• Leadership & Staff Management
• Provides daily operational leadership and oversight for Case Management, Social Services, utilization management, discharge planning, and care coordination functions.
• Recruits, selects, develops, supervises, and evaluates department employees in accordance with hospital policies and leadership expectations.
• Establishes clear performance expectations and monitors employee performance, productivity, competency, and professional development.
• Recognizes employee strengths, provides timely coaching and feedback, and develops performance improvement plans or corrective action when appropriate.
• Promotes a collaborative, accountable, patient-centered work environment consistent with Bay Area Hospital’s Behavioral Standards.
• Identifies department education and competency needs and collaborates with Clinical & Professional Development and other resources to provide appropriate education and training.
• Serves as a subject matter resource and provides guidance to staff regarding complex cases, discharge barriers, utilization concerns, patient/family needs, and escalation processes.
• Case Management, Social Services & Care Coordination
• Oversees the development, implementation, and ongoing evaluation of effective case management, social services, utilization management, discharge planning, and transitions-of-care processes.
• Ensures early identification and proactive management of barriers that may delay treatment, progression of care, discharge, or transition to the next appropriate level of care.
• Promotes interdisciplinary care planning and effective collaboration among physicians, nursing, therapy, pharmacy, behavioral health, social services, post-acute providers, patients, families, and other members of the healthcare team.
• Supports effective management of complex patient populations, including patients with significant medical, behavioral health, psychosocial, financial, housing, transportation, caregiver, or post-acute care needs.
• Ensures patients and families receive appropriate education, resources, referrals, and support necessary for safe and effective transitions of care.
• Develops and maintains collaborative relationships with skilled nursing facilities, home health agencies, hospice providers, behavioral health organizations, community agencies, payers, and other post-acute and community partners.
• Supports processes intended to reduce preventable readmissions, avoidable delays, unnecessary utilization, and gaps in transitions of care.
• Utilization Management & Regulatory Compliance
• Provides oversight of utilization management activities to support appropriate patient status, medical necessity, level of care, and efficient use of hospital resources.
• Ensures Case Management and Social Services practices comply with applicable CMS Conditions of Participation, state and federal requirements, payer requirements, accreditation standards, and hospital policies.
• Supports processes for timely utilization review, patient status evaluation, required patient notices, discharge planning evaluation