University of Miami
healthcare
Manager,CaseManagement
Neural analysis suggests this role is
optimal for Mid candidates.
“Manager, Case Management at University of Miami. Skills: Case Management, Care Coordination, Patient Advocacy, Resource Management. Act as patient advocate/care coordinator. Enhance patient management quality”
What You'll Achieve.
enhancing the quality of patient management; satisfaction; continuity of care; timely cost effective practices; appropriateness and cost effectiveness of treatment; data reporting-Avoidable data; denial data; Physician Advisor reviews; HINN Data
Industry & Context.
Organize and analyze situations and develop analyze data and develop valid conclusions; develop clear, concise policies, procedures; provide clear direction to manage duties in an environment of changing priorities and frequent deadlines
Work weekends if and when necessary
What They're Looking For.
Must Have
Bachelor’s degree in relevant field required, Valid State of Florida RN license required, A Minimum of five years in Hospital Case/Care Management/nursing, 1 year of management, good working knowledge of patient assessment, medical terminology, ability to adapt and facilitate change, Computer knowledge, ability to effectively communicate in English, a professional appearance, JCAHO Standards, Quality Improvement Process, Risk Management knowledge, Infection Control Surveillance and Standard Precautions knowledge, basis regulations in the healthcare setting, Active participant in continuing education and professional groups, CMS, State, Federal and Local governing bodies, Proficient in math applications, use of spreadsheet, ability to operate word processing, advanced written communication skills including grammar, spelling, thorough understanding of all regulations regarding personnel practices, Ability to input data to computer, Ability to interact with others in a professional, courteous, tactful, ability to act as a consultant to case managers, Social Workers and Leadership, Organize and analyze situations and develop analyze data and develop valid conclusions, develop clear, concise policies, procedures, provide clear direction to manage duties in an environment of changing priorities and frequent deadlines, Ability to communicate with others via, ability to read written documents
What You'll Do.
Act as patient advocate/care coordinator
Enhance patient management quality
Manage care of complex patients
Apply review criteria
Perform care coordination
Perform discharge planning
Establish plans of correction
Collaborate with interdisciplinary staff
Participate in quality improvement
Participate in evaluation processes
Assist director with physician issues
Assist director with patient issues
Assist director with family issues
Assist director with multidisciplinary team
Assist director with Managed Care plans
Assist director with legal representative issues
Facilitate delivery of clinical services
Facilitate delivery of community services
Manage observation patient process
Assist Admitting department with bed assignment
Assist Admitting department with appropriate placement
Conduct InterQual® reviews
Conduct EQ Health reviews
Coordinate monthly statistics for data reporting
Generate letters to physicians
Work with physician regarding medical necessity
Facilitate decision making
Establish evaluation program
Establish interdisciplinary treatment plan
Assess patient status
Assess need for continuing care
How You'll Work.
Team & Collaboration
Collaborate with the interdisciplinary staff internal and external to the organization; Act as a consultant to case managers, Social Workers and Leadership
Communication Scope
ability to effectively communicate in English; advanced written communication skills including grammar, spelling; Ability to communicate with others via
Full Job Description
**_Current Employees:_** If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click [here](https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this [tip sheet](https://my.it.miami.edu/wda/erpsec/tipsheets/ER_eRecruiting_ApplyforaJob.pdf). The Case Manager Manager acts as a patient advocate/care coordinator to hospital clients. Provides expertise for enhancing the quality of patient management, satisfaction, continuity of care and timely cost effective practices. The manager coordinates, negotiates, procures services and resources for, and manages the care of complex patients. Applies review criteria to determine medical necessity for admission and continued stay. Additionally, performs care coordination and discharge planning functions Assesses readmissions and assists the quality management process by identifying trends and establishing plans of correction where appropriate. The manager of care coordination collaborates with the interdisciplinary staff internal and external to the organization. Participates in quality improvement and evaluation processes related to the management of patient care. In addition to the above administrative responsibilities, the manager may be responsible to function as a Case Manager as well. This position will assist the director with physician, patient and family issues, multidisciplinary treatment team, Managed Care plans, and when indicated, legal representative(s). Facilitates delivery of clinical and community services to patients and families through effective utilization of available resources. Manage the observation patient process, assist the Admitting department with bed assignment and appropriate placement, conduct InterQual® reviews, EQ Health reviews, coordinate monthly statistics for data reporting-Avoidable data, denial data and Physician Advisor
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