Manager Ed Care Management & Transitional Care

If you are interested apply online and send your resume to anjimenez@mlkch.org
POSITION SUMMARY
The Manager of ED CM & Transitional Care will supervise and direct ED Care Management team that includes RN Care Managers, ED Coordinators and ED Transitional Care Navigators. These services include assessment of ED patients for level of care, appropriateness for admission or observation, HLOC transfers, discharge assistance, and follow up care as appropriate in collaboration with the inpatient Care Management team. Care Management policies for this work initiated and implemented by the Manager.
This Manager role will also provide clinical supervision and oversight to the Transitional Care Navigator (TCN) team including TCN Lead, Transitional Care Navigators, Transitional Care Nurse. Manager will coordinate decision and collaboration related to Transitional Care navigation and post-acute network providers. This role will assume coordination and implementation of post-acute services such but not limited to: OnClick (reduction of readmissions focused on Medicare patients), coordination of Home Paramedic Program, and other programs as assigned by Senior Director.

• This position is responsible for developing and maintaining networks of post-acute providers, facilities and other types of community service providers as directed by the Senior Director of Care Management, Social Work & Transitional Care. The manager will monitor network performance and maintain a positive working relationship between MLK and individual network providers. Manager will identify opportunities to improve post discharge services to reduce readmission and improve community health.

Works collaboratively with other managers within the Population Health Program to support the entire Care Management Department. This role is expected to share in CM Leadership Call on a rotation basis as assigned by the Senior Director for Care Management
ESSENTIAL DUTIES AND RESPONSIBILITIES
1. Manages and supervises the ED CM RNs, ED Coordinators, and ED TCN team to support the MLKCH ED services includes but not limited to assessments, transfers to HLOC, ED discharge needs, and follow up care by TCN team according to CM Department policies.
2. Works in collaboration with the Manager of Inpatient CM and Manager of Social Work Services to support the Care Management Program as well as in support of the Population Health Program at MLKCH.
3. Oversight of Post-Acute Networks the current/planned scope of post-acute networks including:
a. MLK-LA Skilled Nursing Facilities (SNF)
b. MLK-LA Home Health Professional Network (planning)
c. MLK-LA Palliative and Hospice Network (planning)
4. Will supervise and have oversight for assessing need for additional provider networks in collaboration with management given new clinical/social needs and ongoing revisions to the Population Health Strategy utilizing
5. Work with management to identify and vet potential post-acute service providers
6. Identify and facilitates oversight of Post-Acute Network participation of MLK internal and network provider organization stakeholders in the definition, operation and oversight of agreed-to services.
7. Participates in hospital committees and unit specific multidisciplinary conferences as well as staff meetings for the Care Management department.
8. Models leadership and promotes professionalism to assist staff in developing priority setting, team work, and flexibility in support of the Care Management team and in community health activities.
9. Holds clinical and non-clinical staff accountable for the Transitional Care of assigned patients including post-acute care and services, auditing of medical records, to assess compliance, and providing corrective actions as needed to meet patient needs.
10. Participates in the hiring process and identifying and recommending staffing needs with skill mix as appropriate to meet needs of the population.
11. Reviews payroll in Kronos; monitors overtime as well as attendance related to HR policy for time & attendance.
12. Oversee a mix of clinical, operational and business projects including but not limited to ones used reduce readmissions, improve transportation services such as ambulance services, and other clinical services as assigned by Senior Director of CM.
13. Work closely with and in partnership with Care Coordinators, Case Managers, Social Work, TCN staff, and clinical staff to ensure that patients care transitions from MLK entities to post-acute network providers are seamless.
14. Establish and monitor management metrics: quality, outcomes, financial, case volume/mix and provides scheduled reporting to the Senior Director of CM.
15. Develop and revise policies and procedures related to network participation and MLK staff interaction with network providers as well as TCN related work flows and policies.
16. Design and coordinate formal and informal training for staff and providers regarding post-acute services, post-acute networks, and participates in clinical training of the Transitional Care Nurse
17. Collaborate with MLK marketing and public relations in the creation of communication and promotional pieces
18. Assess, report, and communicate joint network status on a periodic basis stakeholders/governing bodies
19. Systematically and continuously evaluate and address internal and external customer concerns/ grievances
20. Attend and assist with network governance including Joint Operating Committees, Steering Groups etc.
21. Collaborates and coordinates services and joint meetings with LA Department of Health Outpatient Clinic staff
22. Collaborates and coordinates functional programs with MLKCH Outpatient Clinics to ensure smooth transitions to community healthcare for MLKCH patients.
23. Collaborates with other CM Leadership to ensure adequate staffing and scheduling to support the functions of the Transitional Care team.
POSITION REQUIREMENTS
A. Education

• Bachelor degree in nursing required. Master degree in related area preferred

B. Qualifications/Experience

• Five (5) years acute care hospital, health plan, and/or ancillary services required.
• RN license required.
• Basic Life Support (BLS) certification
• Workplace violence prevention annually.
• Direct patient care or care coordination, utilization, case/disease management experience a plus
• Experience with Medicaid/ Medi-Cal patients and government programs
• Prior Supervisory or Management Experience in a clinical role required.
• Experience in clinical health informatics is preferred.

C. Special Skills/Knowledge

• Significant knowledge regarding health care provider organizations - acute and post-acute care facilities and providers
• Working knowledge of health plans and typical UM and medical management functions
• Able to navigate communication and decision-making across disciplines and provider types
• Clinical knowledge and the ability to assess situations in collaboration with multiple disciplines in order to arrive at a decision often in pressurized situations

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