Job Description :
This job is accountable for leading a trans-disciplinary care team in the delivery of palliative and care management services to a seriously ill population. The incumbent manages, supervises and coordinates the daily operations of a department providing clinical and administrative leadership and expertise. The incumbent is accountable for staffing and scheduling to ensure care management services and clinical care delivery is effective and completed within defined time frames and according to established processes. The incumbent ensures that team members are clinically competent and adequately trained n order to achieve member engagement targets as well as defined clinical and financial outcomes. Establishes and monitors individual and team performance goals providing feedback and taking action to ensure that goals are achieved. Contributes to the strategic planning process and attainment of goals of the department, the organization and the provider partners.
- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Responsible for implementation of mission, vision, philosophy, core values, evidence based practice (EBP), and standards of the organization, within their defined areas of responsibility.
- Demonstrates and role models professional behavior with all staff interactions.
- Serves as change agent and role model for change to assist staff in accepting and embracing the necessary change.
- Collaborates with physician advisors and partners to share performance metrics and patient care progression goals.
- Leads organization initiatives for daily care progression huddles, prolonged stay forums, and complex care management processes.
- Conducts monthly unit conferences with minutes which include discussions of both unit and organizational activities and goals.
- Completes annual performance appraisals on associates which includes peer feedback process, plan for professional development and employee self-appraisal.
- Promotes departmental shared governance process to include ongoing support through consultation and assistance in eliminating barriers.
- Promotes ongoing development of staff.
- Promotes and encourages specialty certification.
Quality and Patient Safety:
- Identifies, plans, and implements activities in specified clinical departments to promote interdisciplinary collaboration on behalf of the patient and their family to ensure safe and efficient care progression, effective and appropriate transition plans, and excellent clinical and patient experiences.
- Monitors departmental performance in appropriate EBPs, quality and patient safety goals, meeting assigned goals.
- Develops action plan for any goal not met which includes timeline.
- Develops a yearly unit based quality plan with unit based clinical practice and PI council based on identified unit needs.
- Assures departmental participation and compliance with Six Sigma (LEAN) projects goals related to through put and other quality improvement initiatives.
- Assures that department works collaboratively with patients, families, physicians, and members of the interdisciplinary clinical teams to meet established organizational goals for patient experience.
- Reviews making the connection to the care management team contributions and providing feedback to staff at monthly unit conference.
- Investigates and provides feedback for identified patient or departmental concerns. Rounding for Purpose weekly to assess patient and family needs.
- Develops departmental plan to address any improvement needs.
- Meet or show consistent progress toward meeting established patient experience goal(s).
- Demonstrates fiscal stewardship through effective and efficient use of staff, facilities, equipment, and other resources while maintaining patient care standards.
- Maintains both FTE and Goods/Services within established budget, completes variance reports according to established guidelines.
- Provides consistent communication and feedback related to length of stay, resource utilization, and prevalence of avoidable days.
- Coaches teams in use of avoidable day tracking metrics, key factors in level of care determination, and variation in payor requirements.
- Utilizes established tools to monitor monthly budget performance, conducting drill down to explain variances as needed.
Professional Growth and Development:
- Fosters the development of staff through coaching, mentoring, and creating an environment which encourages learning and use of research.
- Assures appropriate orientation, education, credentialing, and professional development for personnel.
- Encourages and facilitates staff membership on evidenced-based practice/research committee, and clinical practice councils.
- Encourage and facilitate attendance at nursing grand rounds according to educational needs assessment of unit/department or network.
- Foster peer review participation with staff an d participate in peer review with other managers.
- Set professional developmental goals with staff member at yearly evaluation.
- Identifies one area for self-improvement annually and develops a plan to improve.
Other duties as assigned or requested.
- Bachelor's Degree in Nursing, Social Work, or Related
- Master's Degree in Nursing, Social Work, or Related
- Clinical or case management experience
- Management/supervisory experience
- Experience leading/working on project teams
- Experience leading a trans-disciplinary care team
- Experience in home care or hospice
LICENSES or CERTIFICATIONS
- Active United States RN (Registered Nurse) or LSW (Licensed Social Worker) license in any state is required upon hire. A DE license is required in addition to the home state license unless the home state license is part of the compact. The additional DE license must be obtained within the first 6 months of employment.
- Professional National Certification
- Written and verbal presentation skills
- Motivational interviewing competency
- Excellent interpersonal skills and the ability to work in a matrix management environment
- Understanding healthcare costs and the broader healthcare service delivery system
- Strong analytic skills with ability to interpret, evaluate and act on productivity, clinical and financial data
- Excellent interpersonal/consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization
- Ability to work in a high performing team environment that requires flexibility
- Excellent organizational and time management skills. Demonstrated ability to handle multiple priorities in a fast paced environment
- Proficient computer skills, including Microsoft Office products
Language (Other than English):
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches / trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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