• Provides managerial oversight to a diverse staff, including RN care/case managers, medical social workers, and other support personnel, facilitating patient care coordination within acute care services. Maintains optimal staffing levels to execute designated care management and utilization management strategies for hospitalized patients, ensuring consistency and continuity in assignments. Collaborates with recruitment professionals to hire qualified candidates, oversees comprehensive onboarding and ongoing education, evaluates performance, and upholds adherence to national care management standards. (50%)
• Collaborates with physician and administrative leaders to ensure completion of requested peer-to-peer clinical payer reviews; keeps team informed of NorthShore care management program performance results (5%)
• Uses data (length of stay, observation status management, time of discharge, discharge destination, denials, appeals, etc.) to drive improvement in patient care management and utilization of health system resources. Regularly shares performance data with staff in order to engage them in improvement activities. (10%)
• Provides consistent communication to staff in an atmosphere of openness that welcomes participation; conducts departmental staff meetings at least monthly. (5%)
• Promotes a positive practice environment that encourages professional growth and accountability. (5%)
• Provides staff support to health system committees; presents data, analysis/interpretation, and recommendations in a concise, coherent manner to appropriate audiences, to include, but not limited to the Utilization Management Committee. (5%)
• Leads and/or participates in improvement activities within the department and more broadly across the organization to promote continuous improvement in clinical and operational outcomes. (5%)
• Independently problem solves operational issues in the department in order to foster positive employee engagement. Keeps other leaders, and departments informed of changes as they occur. (10%)
• Works continuously to achieve “top box” patient engagement results for the department and organization. (10%)

What you will need:

• Bachelor’s Degree in a healthcare related field (Nursing/Social Work/Therapy) required. Master’s degree preferred
• Active, unencumbered license to practice in clinical discipline of Nursing/Social Work/Therapy required
• Certified case management ACMA or CMSA preferred
• Minimum five years of quality management/care coordination/health care experience in a hospital setting
• Minimum three years of management and/or leadership experience

Benefits:

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, and Vision options, including Domestic Partner Coverage
• Tuition Reimbursement
• Free Parking at designated locations
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities