Summary:

In partnership with the Director of Clinical Social Work and Discharge Planning provides leadership to the Case Management staff in the daily operations of the case management program. Participates in the design development implementation and improvement of the Case Management model at The Miriam Hospital and Newport Hospital. 

Responsibilities:

Responsibilities

Provides for leadership of Acute Care Medical/Surgical Case Managers and those on Acute Rehab in the development implementation and evaluation of Case Management Program including orientation continuing education and in-servicing programs. Participates in the interview process and selection of new staff directs daily department activities including evaluation of professional and support staff workflows that enhance achievement of organizational objectives and goals. Recommends selection of staff directs activities and evaluates professional and support staff to optimize achievement of goals and objectives. In collaboration with the Director develops measurements for evaluating staff competency and orientation. Acts as a resource to Case Managers and support staff. Develops department policies and strategic plan.

In collaboration with the Director of Clinical Social Work and Discharge Planning Physician Advisors and nursing leadership identifies institutional needs and determines priorities.

Develops analyzes and adheres to departmental capital and operating budget ensuring appropriate staffing and resources to support the case management standards of practice. Provides for the effective utilization of resources (people financial material and equipment) to meet established goals and objectives.

Acts as a clinical consultant/practitioner for all members of the health care team regarding complex issues in areas of case management (such as hospital location appropriateness of admission and continued stay denials third party payor discharge planning) and pathway design and implementation.

Participates as a member of the Utilization Management Committee in implementing a quality improvement program to continuously evaluate the effectiveness of the Case Management Program identifying affiliate systems issues and new path initiatives. Ensures that the case management process adheres to standards of quality access and fiscal responsibility.

Develops and implements a site-specific quality improvement program to continuously evaluate the effectiveness of the Case Management program in partnership with the Director of Clinical Social Work and Discharge Planning Physician advisors and The Miriam Hospital and Newport Hospital leadership.

Effectively and continually communicates with the staff nursing leadership management and customers to facilitate the flow of information necessary for the success of employees department families and the organization.

Facilitates continuous performance improvement by encouraging innovation supporting reasonable risks taking and maintaining openness to new ideas.

Participates in ongoing independent study education-related professional activities and affiliations to maintain knowledge in the area of patient care services third party payor and managed care requirements and case management. 

Participates in or leads various committees task forces and quality improvement teams as needed.

Other information:

Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.

QUALIFICATIONS-EDUCATION:

Bachelors Degree in Nursing with
current license to practice as a Registered Nurse in the State of Rhode Island.

Masters level of preparation
preferred.

QUALIFICATIONS-EXPERIENCE:

Five years relevant clinical/case
management experience with demonstrated leadership skills.

Experience should demonstrate a
high level of written and oral communication skills.

Also demonstrated working
knowledge of quality assurance utilization management hospital reimbursement
and capitation methodologies is required.

Must demonstrate ability to
identify and negotiate boundaries of accountability and authority within multiple
disciplines.

SUPERVISORY RESPONSIBILITY:

Directs activities of up to 50
professional and support staff members.

Responsibilities include the
interviewing selecting orientating evaluating and as necessary corrective
actions of the staff.

Brown University Health is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: The Miriam Hospital USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union