Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities.

DIRECTOR OF CASE MANAGEMENT AND SOCIAL WORK| Lima, OH

St. Rita Medical Center

Position Summary

Responsible for directing, planning, organizing, and managing functions and resources for the Care Management Department.  Works closely with Care Management Leadership and colleagues to implement leading practices that support a progressive, data- driven, outcomes-oriented care management model.  Fosters integration and strong collaborative partnerships with nursing, quality, hospitalist, and market/facility leadership related to clinical integration activities in order to optimize high quality, cost- efficient care in a timely manner that is patient focused and seeks to improve the experience of care.

Essential Functions

Collaborates with CM leadership and colleagues to achieve leading, standardized practices and processes related to care transition management including readmission prevention, length of stay, advance care planning, daily tam rounding, and patient satisfaction/experience related to care transitions.

Supports national standards for care management scope of service:  Education, Care Coordination, Compliance, Transition Management and Resource Utilization.  

Works closely with community health, ambulatory and population health partners in efforts to support patients across the care continuum. Collaborates with ambulatory and post-acute providers/staff to ensure seamless transitions of care. Works closely with post-acute network partners on key initiatives and efforts to reduce unnecessary PAC utilization, when safe and appropriate.

Partners with facility physician leader to optimize the Utilization Management Committee, providing actionable data related to utilization opportunities identified through qualitative data, and quantitative data analytic platforms such as Quality Advisor, and other facility and system data resources.

Collaborates with our Ensemble partners to support denial prevention, patient classification and compliance for optimal performance and adheres to SOW related to BSMH responsibilities.

Directs daily operations to achieve effective utilization of personnel resources consistent with patient and ministry needs. Directs development of annual departmental goals and objectives, aligns with system CM goals and objectives.

Ensures compliance with federal, state, and local regulations and accreditation requirements impacting care management service.  Routinely audits and tracks for quality assurance, analyzes data to identify opportunities for performance improvement.  Holds staff accountability to follow CM processes to support quality, resource utilization and compliance.

Requirements

Bachelors Degree in Nursing or Social WorkActive Registered Nurse (RN) License or Social Work (MSW)Certification in Care Management within 3 years3 years acute hospital care management experience, preferable in leadership

Many of our opportunities reward* your hard work with:

Comprehensive, affordable medical, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/AD&D
Employer contributions to retirement savings plan when eligible
Paid time off
Educational Assistance
And much more

*Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com