Manager of Case Management - Marianjoy

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

The Manager, Case Management reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Manager, Case Management is responsible for the daily supervision of staff. This position interviews and hires new staff and provides orientation and on-going training/performance evaluation to department personnel. The Manager serves as support and a resource for department personnel, backs up job assignments as needed. 

The Manager, Case Management oversees the day-to-day department function and completion of special projects. This individual serves as the primary liaison for the patient/caregiver, educates patient/caregiver of continuum of care and facilitates discharge coordination. The Manager works in partnership with others in ensuring that areas of responsibility are aligned with the Mission, Vision and Values. This role ensures that policies, procedures and practices support clinical, service and operational excellence. The Manager also functions as a liaison between the leadership, physician partners and staff.

Responsibilities:

Managerial Responsibilities:

• Develops, implements and maintains an effective department orientation program; provides ongoing training, ensuring compliance with hospital/department policies and procedures
• Carries out normal managerial duties and responsibilities, such as interviewing and hiring subordinates, conducting performance appraisals and granting merit pay increases, adjudicating requests for time off or other employee requests, adjudicating formal grievances or responding to other individual employee concerns, recognizing employee accomplishments, etc.
• Collaborates with admissions director to coordinate smooth transition on the continuum of care
• Serves as contact with weekend/off shift questions and needs in regards to case management
• Conducts effective, well-organized periodic staff meetings to communicate pertinent information and resolve identified associate problems/issues.
• Evaluates department workload on an ongoing basis to allow for equitable distribution among work groups.
• Attends required meetings and serves on committees as representation of department.
• Creates and executes effective staffing patterns that hold employees accountable for completing essential job functions within the allotted time frame.
• Maintains attendance records for employees, manages paid time off and coordinates coverage for all positions as needed.
• Adjusts utilization of staff and materials to actual workload.
• Works to develop and implement strategies to improve efficiency throughout the department.
• Maintains current and open communication with leader regarding status, progress and needs of team.
• Administers and documents disciplinary action as appropriate.
• Leads Medicare appeal process, coordinating and preparing all necessary documentation.
• Participates in utilization review process including tracking and appraising outlier days.
• Develops, implements and maintains a process to regularly review case manager’s documentation.
• Identifies and implements process improvement initiatives to improve service quality to those we serve i.e. Outside Medical Appointments, Caregiver Education, etc.
• Serves as liaison to outside referral sources/vendors re: discharge needs/processes (DME/CE)
• Carries out other duties and special assignments as delegated by the leader.
• Demonstrates knowledge of departmental emergency procedures.

Case Manager Responsibilities:

• Serves as the primary liaison for the patient/caregiver, educates patient/caregiver of continuum of care and facilitates discharge coordination.
• Follows patient from admission to discharge to/from the facility/program.
• Communicates to external payers on behalf of patients.
• Acts in partnership with the physician to closely monitor utilization of the patient’s resources and works with the patient/caregiver to plan and facilitate a timely and appropriate discharge plan.
• Coordinates and documents care conferences, assists in reconciling FIM discrepancies between disciplines, family meetings, family education and graduation day.

Financial Management and Viability

• In accord with the overall financial planning process and guidelines, assists in the preparation of budgets.
• Partners with financial services in regards to denials and use of caregiver funds
• With the assistance of assigned financial staff, reviews periodic financial statements and reports and makes changes in resource allocation, spending and other relevant business activity, to ensure the financial viability and budget compliance.
• Supports and adheres to the financial controls and related policies and procedures and ensures that administrative and business activities are conducted in support of operational excellence.

Human Resources Management

• With the support of an in coordination with the Human Resources and Organization Development function, maintains positive personnel relations and strives to make the organization an employer of choice by ensuring that employee questions and concerns are addressed responsively
• Ensures compliance with laws and regulations and adherence to HR/OD policies and procedures.
• Ensures that performance management programs for staff and physicians are effectively administered and that all staff receive on-going feedback and coaching on job performance, competencies, values-based behaviors and developmental needs.

Compliance and Privacy

• Ensures that policies and procedures regarding corporate compliance and privacy of patient and employee information are observed.
• Exercises due diligence in contracting and other activities with legal risks and uses the services of the Office of General Counsel as appropriate.
• Personally, models professional confidentiality and discretion in all communications and exchanges of information.

Required:

• Master’s degree in Social Work or Nursing with BSN, MSN preferred
• Current Licensure in the State of Illinois.
• 3 to 4 years of previous experience in a health care setting, preferably in rehabilitation.
• Commitment to a high standard of customer service and support of continuous quality improvement.
• Functions as a leader, team member and fosters collaboration between multiple parties.
• Demonstrated ability to manage, teach, make independent decisions and assume responsibility.
• Strong interpersonal communication skills, verbal and written.
• Considers diverse opinions and incorporates them into the decision-making process.
• Exhibits creative and positive problem-solving abilities.
• Thinks conceptually and applies concepts in a practical application.
• Assimilates information from a variety of sources, analyzes information and determines a course of action.
• Plans, organizes and effectively presents ideas and concepts to individuals and groups.
• Working knowledge and experience with PC-based applications, i.e. Word, Excel, PowerPoint, Outlook

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.