Care Mgr Job Description
Care Mgr Duties & Responsibilities
To write an effective care mgr job description, begin by listing detailed duties, responsibilities and expectations. We have included care mgr job description templates that you can modify and use.
Sample responsibilities for this position include:
Care Mgr Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Care Mgr
List any licenses or certifications required by the position: BLS, CPR, AHA, ACLS, A.S.E, CHSM, IL, PALS, ASE, URAC
Education for Care Mgr
Typically a job would require a certain level of education.
Employers hiring for the care mgr job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Nursing, Education, Management, Health, Associates, Business/Administration, Social Work, Health Care, Healthcare, Supervision
Skills for Care Mgr
Desired skills for care mgr include:
Desired experience for care mgr includes:
Care Mgr Examples
Care Mgr Job Description
- Act as a liaison between primary care and behavioral health for members who need behavioral health treatment follow up
- Investigate quality of care concerns
- Oversee/conduct HCBS/SNF provider monitoring
- Monitor the delegated providers
- Communicate with the state regulator
- Participate in immediate jeopardy situations
- Comply with required regulatory deliverables including the annual LTC QM Plan
- Maintain/enhance interdepartmental professional relationships
- Manage and monitor Referral coordinator productivity
- Work closely with Customer Care and Operations senior leaders to assess Center performance
- Manage the implementation of the Customer Care training curriculum and Leadership Development curriculum within respective Centers
- Define business and performance objectives for Customer Care training initiatives
- Partner with the Director Training Delivery on curriculum reviews, additional training requirements and trainer certification for the Customer Care organization
- Manage Customer Care training delivery staff
- Direct management employees in the development of strategies and implementation of tactics in support of business and financial plans
- Develop, direct, manage, evaluate and instruct managers of bargaining unit or non-exempt line employees in the department
Care Mgr Job Description
- Develop and implement QM projects and QM Work Plan Activities
- Evaluate complex data and information sets
- Interfaces with management to collect statistical, utilization, financial, quality and risk performance data for analysis
- Evaluates analyses and identifies high risk populations and makes strategic program recommendations
- Conducts research, identifies industry standards and new innovative practices for analysis
- Prepares operational analysis, flow charts, presentations and reports, as required by program specifications
- Presents analysis and recommendations to management
- Processing all material / stock order transfers and drive end to end order management processes
- Troubleshooting in purchase / sales order processes and derivation of possibilities for enhancement
- Process import export orders and the respective shipping processes with prioritization of different shipments
- Operational decisions are made without supervision
- Provide performance feedback and decision into final performance ratings and salaries the Customer Care Center team
- Bachelor's degree in Nursing from an accredited institution (degree will be verified)
- Current RN license for state in which the nurse practices
- Bachelor’s Degree in Health, Business or Financial Administration or related field, required
- Knowledge of ambulatory care, practice management, practice optimization and insurance reimbursement within an ambulatory and/or acute care setting
Care Mgr Job Description
- Cooperation with the finance department to resolve invoice and pricing issues
- Monitoring and evaluation of all orders, goods in transit and sales processes preparation of order reports
- Acts as a regional care management quality assurance (QA) leader, education leader, consultant, and care management mentor
- Collaborates with regional and system leaders to assess educational needs, develop an education plan and define measures which effectively evaluate each scope of service
- Works in concert with regional and system leaders to develop a departmental QA/clinical audit plan, audit tools, and scorecards
- Works in concert with regional and system leaders to develop and coordinate skills and competency evaluations
- Implements appropriate education interventions, including coaching, skills pass-offs, online learning, to ensure an effective education program
- Implements the regional case management QA/clinical audit plan by conducting routine and focused quality reviews/clinical audits
- Meets with regional and system leaders on a routine basis to reassess educational needs and ensure regulatory, contractual, and standards of practice and documentation are met
- Consults with regional and system leaders around appropriate quality improvement interventions needed to improve performance outcomes
- Business Process Re-Engineering/Simplification
- Functional knowledge of accounting practices for A/R and A/P
- Practical experience in a similar position is a plus
- Adheres to established best practices
- Demonstrates commitment to safety by establishing an environment in which safety issues are promptly reported and appropriate actions are taken
- MSW or NP
Care Mgr Job Description
- Responsible for sustaining continuous and relevant regional care management education and QA/clinical audit programs and evaluating and updating the plans, as appropriate
- Educates regional care management leaders and staff to communicate regulatory, contractual, practice and documentation expectations
- Provide consultation and direction to regional leads for time spent performing QA/clinical audit activities and educational activities
- Participates on regional and system task forces, development teams, and workgroups
- Leads regional care management quality improvement (QI) teams
- Maintains clinical competency by staffing, shadowing, coaching, rounding
- Manage, contain, and continuously improve warranty spend
- Participate in Lean initiatives to improve overall efficiencies of the Division
- Communicate and facilitate training to FMs on product or process issues to eliminate long-term risk
- Assist PIM in identifying top warranty spend opportunities
- Minimum 3 years Hospice experience
- Minimum of 3 years Palliative Care experience
- Masters in Nursing or a related field, or Masters in Social Work
- Clinical knowledge and analytical abilities to formulate effective care planning and deliver appropriate care
- Able to demonstrate the knowledge and skill necessary to provide care based on physical, psycho/social, educational, safety, and related criteria, appropriate to the Hospice and Palliative Care patients services, as related to the principle duties and responsibilities of the position
- Bachelor’s Degree in Health Administration, Business or related field, required
Care Mgr Job Description
- Facilitate continuous throughput of patients from all points of entry by utilizing effective communication, swift clinical decision making and planning for staffing needs
- A liaison between all clinical departments, hospital administration and ancillary support services
- Directly manages the Patient Placement Coordinators and the Administrative Nursing Supervisors
- Empowered to serve as a leader within level of authority
- Promotes/supports shared decision making by empowering associates through delegation of clear responsibility, authority, and holding them accountable
- Responsible for recruitment, selection, and retention of personnel
- Ensures compliance with Hospital State, Federal and accreditation regulations in reference to patient care and the physical environment
- Assists in communicating shared vision, mission, and values with department which motivates others to achieve strategic goals
- Assumes responsibility for staffing and scheduling associates and appropriate utilization of personnel
- Develops, implements, monitors, and maintains accountability for budget in defined area of responsibility.·
- Minimum of three (3) years related experience including licensed homecare service and two (2) year progressive management experience
- Strategic thinker, able to work independently
- Able to drive results and work with cross functional teams
- Ability to adapt to new circumstances, information, and challenges
- 8 - 10 years f experience related to standards and measurements, technology, systems and processes, including project consultation (preferred)
- Prove ability to satisfy customer needs and develop alternatives to resolve issues