Coordinator/manager job description

The Manager of Care Coordination supports the Director of Care Coordination Management in implementing and evaluating all activities of the Case Management Program. The Manager will directly supervise the social team and provide oversight for the Case Management staff in the absence of the Director. The Manager will support the development length of stay and resource reduction strategies, best practices and makes recommendations for process improvements. The Manager, in collaboration with the director, physician and administrative leadership and interdisciplinary team, will assist with coordination of patient care and service to maximize efficient and cost effective use of hospital resources and promotes high quality patient care within the healthcare continuum. Additional areas of focus include, but are not limited to, achievement of desired optimal outcomes, and facilitation of timely and appropriate transitions of care.
M inimum Requirements:

+ Graduate Degree

+ Licensed Masters of Social Work

+ 3 - 5 Years Supervisory and/or administrative experience in hospital Case Management an/or Social Work Leadership position

+ 1 - 3 Years Management experience in Acute and Population Case Management setting preferred

+ License of Social Work Upon Hire

+ Certified Case Management (CCM) (ACM) within 7 Days of beginning employment

Key Responsibilities:

+ Adheres to and/or maintains departmental policies and procedures, to be regulatory compliant with The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), OSHA, safety standards, or other regulatory agencies as applicable.

+ Demonstrates flexibility required to meet changing priorities.

+ Maintains respectful working relationships with co-workers and encourages the team approach.

+ Approaches work in a manner that makes quality improvement a part of every activity.

+ Provides a well-thought out decision or response; obtains and analyzes all pertinent information available in order to make the most informed decision/response based on factual and objective data.

+ Works cooperatively with Director and those in leadership positions. Supports department expectations and participates in departmental activities, e.g. staff meetings, education, projects, and communications. Cross trains to duties to support the department.

+ Demonstrates a consistent level of performance; maintains progress on work assignments and meets deadlines. Seeks guidance as necessary for performance of duties.

+ Demonstrates appropriate and effective conflict resolution skills.

+ Address issues with individuals involved in a courteous and professional manner and escalates issues to Director as necessary.

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Serve as primary point of contact for Transition of Care operations and oversee Transition of Care staff. Will act as liaison for Transition of Care directives from DHHS. Communicate cross functionally across departments to achieve optimal member transitions.
Primary point of contact and liaison for all Transition of Care Operations

Assist with daily, weekly, monthly reporting requirements

Service as subject matter expert on Transition of Care operations

Oversee transition coordination staff performing member transition of care activities

Coordinate member rounds for transition of care reviews with cross functional department participation i.e. care management, utilization management, medical director, pharmacy, AMH/LHD/CIN providers

Education/Experience: Bachelor's degree in a healthcare related field. Three years of related experience are required.

DE Only: Housing and Transition Manager who is an expert on the provision of housing and affordable housing resources and supports member transitions between care settings and from institutional to community settings. This position shall oversee sufficient dedicated staff to address the housing and transition needs of members. The Housing and Transition Manager shall be responsible for:3.20.2.1.25.1 Developing innovative solutions and practices to expand housing options, assistance, and coordination for members;

3.20.2.1.25.2 Providing case managers, care coordinators, service coordination and Contractor network staff with education and up-to-date information designed to aid members in accessing and maintaining affordable housing options;

3.20.2.1.25.3 Identifying members with housing needs and making appropriate housing program referrals (e.g., SRAP, PRA Demo), referrals to community and covered and non-covered services and coordinating with case managers, care coordination and service coordination staff, as applicable;

3.20.2.1.25.4 Developing procedures, resources, and strategies to ensure successful member transitions between care settings and from institutional settings to community based care. Efforts shall address and prevent transition related barriers. This may include, but not be limited to; obtaining and maintaining safe, stable, and affordable housing, facilitating special needs accommodations, providing housing referrals and application assistance, arranging for home modifications (for DSHP Plus LTSS members only), facilitating complex member transitions, attending meetings with applicable State agencies, including coordination with DSAMH and DSCYF, and monitoring and ensuring the success of transitions;

3.20.2.1.25.5 Supporting case managers with DSHP Plus LTSS member nursing facility transitions and post transition activities as outlined in Section 3.8.7, Nursing Facility Transition; and

3.20.2.1.25.6 Submitting member transition information and data, as specified by the State

License/Certification: Current, valid and unrestricted LPN, LVN, Social work or RN preferred

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

**TITLE:** Manager, Transition Coordination

**LOCATION:** Newark, Delaware

**REQNUMBER:** 1371484

Responsibilities

Play a key role within a world-class, award-winning health system. Lead, inspire and motivate a team of outstanding clinical professionals. Take your career in an exciting new direction. You can do all this and more at UCLA Health.

In this vital position, you will oversee the daily administrative and operational functions of the Comprehensive Care Coordinators (CCCs). Your role will involve collaborating with the Sr. Manager and the Clinical Managers of Ambulatory Care Coordination to apply best practices and evidence-based research in the development and design of innovative approaches for managing population health. You will also implement established and innovative approaches to population-based care coordination and transition management. You will provide administrative leadership to operational areas for both direct and matrix accountability, including those that support the medical home and UCLA innovation models. You will work to ensure overall member satisfaction and operational efficiencies.

Qualifications

We're seeking a flexible, self-directed leader with:

* One or more years of supervisory experience in an ambulatory environment

* Solid background in healthcare administration, business, or public health

* Experience with population management and care coordination

* Knowledge of patient-centered medical home implementation/operations

* Understanding of URAC and NCQA guidelines for patient-centered medical home

* Expertise with insurance eligibility checking, prior authorizations, referrals, and orders for commercial and government payors

* Outstanding analytical and problem-solving abilities

* Excellent communication, interpersonal and organizational skills

* Ability to integrate competing demands of an outpatient setting into a productive working environment

* Ability to diplomatically communicate difficult information to physicians and leadership

* Experience developing quality improvement action plans

* Knowledge of medical terminology and health system registration procedures

* Ability to work weekends as necessary

* Strong leadership and independent decision-making skills

* Computer proficiency with EMR, Word, Excel, and Outlook

UCLA is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart.