Manager of Care Coordination and Planning (RN)

Description

Maine Medical Center
Management/Leadership
Req #: 65334

Maine Medical Center - Portland is seeking a Manager of Care Coordination and Discharge Planning (RN). This individual is responsible for the daily planning, assessing, monitoring and managing of the patient continuum of care. In partnership with other Care Management staff and physician leadership, to ensure all patients admitted to Maine Medical Center have a length of stay consistent with or less than medical and/or surgical criteria geometric mean length of stay.

The Manager of Care Coordination and Discharge Planning (RN) serves as a resource for the care management team and other departments, and reports to the Director of Care Management. This position contributes toward the overall development of programs and services to provide for the needs of patients/families, physicians and staff. He/she assists the Director in providing strategic leadership to ensure equitable distribution of resources and delivery of high quality, cost-effective healthcare and efficient management of Care Management staff in accordance with goals, objectives, policies, and applicable regulatory agency rules and regulations.

The Manager of Care Coordination and Discharge Planning (RN) ensures a strong focus on discharge planning beginning on the day of admission, to meet the needs of the patient/family as much as possible while remaining in compliance with federal, state and local regulations. This manager will be under the direct supervision of the Director of Care Management, and under the indirect supervision of the Chief Financial Officer.

This is a Monday-Friday position and will sit onsite at the Bramhall Campus.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

• Education: Bachelor's degree in Nursing or Master's degree in SW. Master's degree in Nursing or Social Work.
• License/Certifications: Certification as a Professional in Healthcare Quality (CPHQ), Certified Case Manager (CCM) or Accredited Case Manager (ACM). Certification in coding, utilization management/review, and in the quality improvement process preferred.
• Experience: 5 years' RN/SW experience with either prior care management, authorization, utilization review, and/or discharge planning. Minimum three (3) years of supervisory experience including but not limited to corrective actions, training, employee development/ assessment, and wage and hour regulations preferred. Minimum five (5) years of acute hospital experience.
• Strong clinical nursing background. Knowledge of professional nursing principles, clinical processes and clinical interventions.
• Working knowledge of Medicare guidelines, as they appear in the Federal Register, pertinent to inpatient hospital and outpatient ambulatory services.
• Knowledge and ability to implement a quality improvement process.
• Leadership skills/experience, to be able to manage and motivate divergent personalities.
• Data management proficiency, with ability to develop and carry out studies.
• Communication skills to facilitate meetings and exchange information with staff, other departments, healthcare professionals, and administrators. At ease with public speaking.
• Ability to lead and implement change management and process improvement activities.
• Ability to understand and utilize data to improve performance.
• Strong communication, presentation, leadership, analytical and problem-solving skills.
• Significant knowledge of applicable federal and state laws and regulations related to healthcare (i.e., TJC and all applicable Medicare and Medicaid regulations).
• Ability to perform medical record reviews interpreting, abstracting, aggregating, analyzing and reporting complex clinical data obtained from medical records. Knowledge of clinical practice guidelines and the appropriateness of clinical interventions. Maintains a reporting and recording system.
• Knowledge of computer software applications.
• Knowledge of payer requirements, discharge planning regulations, utilization review regulations and accreditation standards.
• Knowledge of data collection, analysis and data presentation.
• Ability to establish priorities, meet deadlines and manage the department's productivity standards in management of the worok assignment.
• Ability to lead and problem solve in a proactive creative manner using sound judgment based on factual information and clinical knowledge.
• Demonstrated ability to communicate verbally and in writing to internal and external constituencies.
• Knowledge of InterQual, Milliman, Midas and information systems.
• Knowledge of ICD-9-CM and CPT coding preferred.
• Knowledge of computer software applications such as MS Power Point, MS Word, Access, and Excel.
• Certification in coding, utilization management/review, and in the quality improvement process preferred.

Hiring Scam Alert

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Additional Information

With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.

We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.

MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.

If you have questions about this role, please contact tabor.badger@mainehealth.org