Manager of Acute Care Transitions (FT Salaried)

PURPOSE OF THE POSITION

The purpose of this position is to provide daily operational oversight of the interdisciplinary care transition team. The acute care transition manager fosters communication and collaboration across the health system, develop safe, smooth, and sustainable transitions of care to the post-acute care setting.

JOB DUTIES/RESPONSIBILITIES

Duty 1: Provides leadership to the Acute Care Transitions Team, including the disciplines of Social Work, Case Management, Utilization Review, and Emergency Department Care Navigation to support evolving and continuing processes for patient transitions.

Duty 2: Works in conjunction with ambulatory care navigation team and other service providers for optimal utilization of available resources to ensure best possible outcomes for patients and their caregiver transitioning from Care Navigation to Acute Care services.

Duty 3: Works with leadership across the organization participating and collaborating on various committees around service area. Works towards quality improvement by analyzing data and service scores with goal to find opportunities for growth of programs and continual process improvement.

Duty 4: Accountable for optimizing existing processes and implementing new processes to obtain safe, smooth and sustainable transitions to and from the acute to ambulatory care setting in coordination with ambulatory care navigation team. Responsible for ensuring care coordination during acute care stay.

Duty 5: Accountable for following processes compliant with regulatory and insurance payer status, documentation, and billing requirements

Duty 6: Participates in development of new and ongoing Policies and Procedures within all responsible departments and related organizational function areas. Responsible for oversight of rights and responsibilities chapter of Joint Commission

Duty 7: Establishes and maintains collaborative working relationships with medical providers, organizational, and community resources.

Duty 8: Responsible for oversight of utilization of services for patients in acute care setting including status determinations, managing length of stay and advocating for payment of appropriate services during acute care stay.

Duty 9: Maintains position as Utilization Review committee chair. Works in collaboration with ambulatory care navigation team in collection of data, and improvement of transition processes as needed. Collects and manages data related to acute transitions of care.

Duty 10: Develops and implements organizational policies and procedures for the facility or medical unit. Responsible for policies around Joint Commission’s chapter on Rights and Responsibilities.

Duty 11: Monitors the use of diagnostic services, inpatient beds, facilities, and staff to ensure effective use of resources and assess the need for additional staff, equipment, and services.

Duty 12: Maintains computerized record management systems to store and process data to produce reports, develop policy and procedures for service area.

REQUIRED QUALIFICATIONS

• Current Ohio Licensure as a Registered Nurse
• Nursing experience 5+ years, 2-4 years in Care Coordination and or Managed Care
• Knowledge and experience with applying federal, state and local coverage determinations, billing compliance and regulations
• Individual should be able to demonstrate knowledge and skills necessary to coordinate appeals, manage denials, and apply insurance status requirements in the acute care setting
• Knowledge and training with regulatory auditors, such as RACs, MICs, OIG, and other auditing agencies.
• A valid driver's license is required (if you do not have a valid Ohio driver's license you must obtain one within 30 days of your residency in the state). You must also meet BVHS's company fleet policy and insurance company requirements, and any other requirements that may be required to operate a vehicle.
• Positive service-oriented interpersonal and communication skills required.
• Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department. The individual must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient status. Must be able to interpret the appropriate information needed to identify each patient's requirements relative to their age-specific needs and to provide the care needed as described in the area's policies and procedures

PREFERRED QUALIFICATIONS

• Previous Supervisory, leadership experience
• BSN
• Master’s Degree in related field

PHYSICAL DEMANDS

This position requires a full range of body motion with intermittent activities in walking, sitting, lifting, bending, squatting, climbing, kneeling, twisting and standing. The associate will be required to lift 50 pounds or more. This position requires individuals to lift work above the Shoulder. The associate must have corrected vision and hearing in the normal range. Individual must have excellent verbal communication skills to perform daily tasks.

***This position is classified at risk for possible occupational exposure to blood borne pathogens (HBV) HIV, etc.) Maximum exposure in regard to universal precautions.