Care Management Team Leader, - Galveston Care Management

JOB SUMMARY:

Expert RN or MSW Care Coordinator with a focus on transitions of care – possesses an in-depth knowledge and skill level to be a resource to other Care Coordinators and staff. This includes and understanding of the Transitions of Care, Center for Medicaid and Medicare Services (CMS) rules, The Joint Commission standards and other regulatory requirements. Must possess an extensive understanding of the post-acute care options, Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs) and managed care concepts that drive appropriate resource utilization.  The role is intended for the advanced Care Coordinator, who in addition to their routine assignment, takes on initiatives to enhance the betterment of the overall department. This individual serves as the mentor for other Care Coordinators and social workers in regards to the guidance and management of complex cases an

REQUIRED EDUCATION / EXPERIENCE:

RN with BSN, or Master’s degree in Social Work; and five years of Care Management or healthcare experience. Must possess and maintain a current RN license or valid temporary permit to practice in Texas or must be licensed to practice as Social Worker in Texas (LMSW, LCSW). Current BLS required collaborates and promotes a team atmosphere with all colleagues and stakeholders.

JOB FUNCTIONS:

In addition to meeting all the other job functions outlined in the Care Coordinator position, the Care Coordinator Team Leader will be responsible for the additional job functions:

• Serves as a subject matter expert in all facets of Case Management 
• A clinical liaison for contract placements to ensure appropriate use of resources and coordination of care
• Ensures that new personnel complete orientation requirements and documents competency
• Participates on interdisciplinary committees within the institution
• Leads complex care meetings and provides closure on outstanding cases
• Communicates with physician or downstream providers on difficult cases that may require increased care coordination
• Monitors individual worker productivity and recommends staffing levels to improve productivity. Promotes patient-centered care and supports UTMB’s values
• Identifies and implements cost containment strategies for the hospital and the patient
• Provides coverage for staff or leadership as needed