case management lead- tuality healthcare
When it comes to community, everyone has a part to play.
For us, it's an honor and a duty to help those near us
receive the best medical care possible. That's why,
since our beginnings in 1918, we've worked hard to
provide quality, convenient care for our patients.
Throughout our growth and expansion, we have become a
strong community-governed, not for profit, healthcare
system. We take pride in our excellent quality of work
and all of our services provided, creating an atmosphere
that benefits our staff and patients alike.
At Tuality Healthcare we recognize that the foundation
for providing excellent care begins with recruiting
exceptional candidates and cultivating the talents of
our current employees.
Summary of Duties
Responsible for oversight of the Case Management staff
and daily operations of the department. Analyzes patient
medical records concurrently and/or retrospectively for
quality assessment, utilization review, and discharge
planning criteria. Provides concurrent reviews and
retrospective reviews to insurance carriers for
authorization of services. Coordinates discharge plans
and orders for patients leaving the hospital. Oversees
and/or submits weekly catastrophic and quarterly reports
and statistics for presentation to the Utilization
Review Committee and Admin Team. Develop, teach and
monitor orientation program for new Case Management and
Social Work employees to ensure consistency. Advises TCH
committees in the development and implementation of
utilization, quality and cost management approaches to
achieve effective performance in the health care
continuum and transitions of care.
HIRING COMPETENCIES - skills & experiences the applicant
should bring to the job.
1. Education: Graduate of accredited School of Nursing,
preferably with a bachelor of science in nursing, or
completion of BSN or MSN within 5 years.
2. Minimum 2 years previous supervisory experience
3. License: Current license as a Registered Nurse by the
Oregon State Board of Nursing required. CCM (Certified
Case Manager) preferred.
4. Competent in Case Management, Utilization Review and
Discharge Planning required.
5. Strong clinical nursing skills with at least 5 years
hospital experience in varied clinical settings.
6. Demonstrates ethical commitment to quality assurance
and confidentiality of all data and information.
7. Advanced communication and interpersonal skills that
utilizes consideration body language, filters,
listening, paraphrasing, and questions with customers of
diverse ethnic and cultural backgrounds. This also
includes the skills to obtain and interpret information
appropriate to patients' needs and age as required for
assessment, range of treatment and patient care.
8. Ability to develop case management care plans and
solutions utilizing problem-solving skills.
9. Knowledge of community health and social service
10. Ability to document care in the Electronic Health
Record accurately and efficiently.
11. Emulates THC dress code and Code of Conduct that
incorporates presenting a good first and lasting
impression by personal appearance and interpersonal
12. Experience working in highly confidential settings.
13. Possesses excellent customer service, telephone
skills and interpersonal communication abilities both
verbal and written.
14. Familiar with computerized word processing, database
and spreadsheet programs.
15. Self-directed and must be able to follow through on
projects and implement ideas and programs with minimal
16. Demands creativity, flexibility and the ability to
work under stress.
17. Ability to follow through on projects with attention
to detail and accuracy.
18. Ability to effectively supervise others and create a
welcoming environment for staff.
19. Knowledge of medical staff organizations, managed
care plans, quality improvement, and utilization
PHYSICAL REQUIREMENTS AND HAZARDS:Percentage of Time Spent:
% of time
Lifting / Carrying
Physically Demanding Tasks: Eye-strain from continual
Case Management-82000 - 2 years ago