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Spartanburg Regional Healthcare System Mgr-Patient Engagement & Care Coord in Spartanburg, South Carolina

Position Summary

The Manager of Care Coordination/Patient Engagement is responsible for the leadership of the Patient Engagement team. This position works to organize team members effectively manage patient care activities and information to achieve a better and safer, more effective patient care. Must Communicate and share knowledge between payers and clinical staff on an ongoing basis. Ensure that care management processes are aligned with and supporting evidence-based medicine, work with each payer and be aligned with the organizational business strategies. This involves the implementation and deployment of new programs involving motivational interviewing, care coordination, care transitions and services necessary for improving patient care.

Minimum Requirements

Education

  • BS in Related Field

Experience

  • 5 years of experience in outpatient setting, population health, social services, home health, or other health care setting. Program management experience in a clinical setting

License/Registration/Certifications

  • Valid Driver’s license with good driving record

Preferred Requirements

Preferred Education

  • N/A

Preferred Experience

  • Team Lead experience

Preferred License/Registration/Certifications

  • N/A

Core Job Responsibilities

  • Lead part of the care management team that may consist of senior care coordinators, nurse navigators, medical management nurses, and support staff.

  • Responsible for developing new associate training and conducting periodic professional development training such as case review, motivational interviewing, and continuing education for staff

  • Accurately measure productivity and care management quality indicators for each associate to ensure their meeting the established standards

  • Understand that the care management team serves patients by engaging, educating and facilitating the resolution of any healthcare needs

  • Develop a method of population risk stratification and prioritization

  • Ensure coordination and cross training within the team

  • Develop and execute hand off procedures for members as they transition through levels of care or through intensive health management programs

  • Establish and maintain relationships with selected payers and vendors necessary to facilitate communications and reporting as it relates to care coordination and quality indicators

  • Develop communications processes with physicians and providers to optimize patient visits and the team approach to healthcare

  • Develop and manage wellness programs and quality initiatives as needed

  • Properly handles member records to ensure compliance with patient health information applicable to the preservation, accuracy, and completeness of communication and/or retention of patient information, meeting all HIPAA regulations and the HITECH Act provisions as required by law

  • Recognizes cultural diversity

  • Has responsibility for the overall management and operations for all Care Coordinators, Community Health Workers and Care Transition staff in the organization.

  • Responsible for the monitoring of quality and productivity measures and, developing strategies for improvement within RHP and the team.

  • Implements Care coordination Interventions including but not limited to disease management, condition management, Care Transitions, etc.

  • Identify opportunities for various members intervention, in order to promote compliance and improve clinical outcomes by contacting the members, assisting with appointments, closing care gaps, retrieving missing documentation, and basic life needs, etc.

  • Assign cases and coordinate responsibilities of staff.

  • Review client cases with individual staff members on a regular basis, as well as providing supervision on an as-needed basis.

  • Be able to identify and refer patients to various Interventions within the Care Management Team.

  • Professionally resolve member/patient requests and concerns.

  • Evaluates patient care data to ensure that care is provided in accordance within guidelines and organizational standards.

  • Proactively collaborate with providers, community resources, and other colleagues to help the team better engage members achieve the best possible outcomes.

  • Develop and plan for continued education for staff on various topics such as chronic disease states, community resources, EPIC, Motivational Interviewing, etc.

  • Be able to collect, analyze and provide data for payers, clients and customers, as needed.

  • Seek ways to improve and promote quality healthcare for the care coordination team.

  • Properly handles member records to ensure compliance with patient health information applicable to the preservation, accuracy, and completeness of communication and/or retention of patient information, meeting all HIPAA regulations and the HITECH Act provisions as required by law

  • Provides input into strategic decisions that affect the functional area of responsibility.

  • Participate in Collaborative Care Committee and Population Health Committee, Payer Meetings as requested/needed

  • All other duties as assigned

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