Manager Inpatient Care Management

The Manager for Inpatient Care Management is responsible for supervising staff effectiveness and expenses in alignment with objectives while striving to enhance the excellence of patient care distribution. They collaborate extensively with nursing associates to have a say in care schemes and confirm the delivery of ongoing and accurate information concerning care duration and discharge preparation. These tasks encompass guaranteeing conformity with regulations and recognizing member benefit entitlements.

Essential Job Function:

• Accountable for the inpatient care management team and tasked with managing utilization review nurses who operate within a matrixed framework.
• Manages case managers, social workers, and a diverse group of team members.
• Assumes the chief role in ensuring patient development while in the hospital setting.
• Facilitates coordination and management of the length of inpatient hospital stays, as well as the determination of discharge arrangements for individuals, by partnering with UR nurses to conduct real-time evaluations based on InterQual or Milliman benchmarks for admission in emergency settings. Regularly assesses the appropriateness of medical care required by patients and organizes supplementary services for marginalized populations.
• Manages the development of leads and verifies the finalization of documentation.
• Tasked with overseeing day-to-day activities through direct staff members.
• Manages the care administration responsibilities throughout the acute care facilities, aligning with protocols and laws set by federal, state, and municipal authorities.
• Supervises the coordination of patient care and management of daily operations in acute care settings, ensuring that patients receive appropriate care at the correct time and in suitable locations in compliance with regulations.
• Establish partnerships and synchronize efforts with our Post-acute network collaborators and VBCI authorities to create a seamless and patient-focused flow between different healthcare settings.
• Responsible for overseeing the discipline of leads to conduct daily progress rounds and maintain accurate records.
• Bears the responsibility of ensuring regulatory compliance and fiscal accountability within designated areas.
• Regularly watches over metrics and data to confirm the provision of premium care at minimal expenses.
• Responsibilites beyond the usual scope.

Education

• Required: Bachelor s degree in Nursing or Business Preferred: Master s degree in Nursing, Social Work, or Business

Experience

• Required: Minimum 3 years of experience managing in a health care setting, preferable including utilization management, case management, and/or social work experience.

Licensure/Certification/Listing

• Required: Current ACM-RN or CCM certification or obtain within one year of hire.