Manager, Inpatient Case Management

Manages the day-to-day operations that are directly associate with the clinical case management with the Kaiser Permanente (Emory) core hospitals. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation, and others as assigned.

• Assists in developing and maintaining policies and procedures for the Service Area or Medical Center related to Utilization Management.


• Collaborates with the multi-disciplinary teams to plan and coordinate care across the continuum.


• Coordinates and manages members care with non-KFH hospital facilities and providers. Identifies risk management and quality of care issues across the continuum.


• Surfaces issues and any suggestions to the appropriate multi-disciplinary team members.


• Manages transportation program to ensure appropriate utilization of resources which meet Health Plan guidelines and patient needs.


• Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across the continuum of care.


• Assists in conducting statistical studies in utilization trends, patterns, and outcomes.


• Hires, trains coaches, disciplines professional and clerical support staff.

• Minimim four (4) years of experience in management /leadership in a hospital or outpatient setting.


• Minimum three (3) years of clinical nursing in an acute care setting.


• Minimum three (3) years of previous experience in utilization management/discharge planning activities in acute care setting required.

• Graduate of accredited school of nursing or Bachelors Degree in Nursing or health care related field such as management, health services administration or four (4) years of experience in a directly related field. High School Diploma or General Education Development (GED) required.

• Registered Professional Nurse License (Georgia)
  

• Working knowledge of all federal, state, local and regulatory requirements.
• Functional knowledge or computers.

• CCM/ANCC Certification or Board Certification equivalent preferred.
• Masters degree in Nursing or Case Management.