Swedish Medical Center Case Management Manager - Case Management in Seattle, Washington
Swedish Medical Center is hiring for a Case Management Manager to manage the Case Management Department at Swedish. We are seeking a dynamic leader that can provide system based focus for our various locations with a focus at Cherry Hill.
The Manager Case Management is responsible for the daily management and organization of all activities and staff within the Case Management Department including care coordination, case management, discharge planning, utilization management, social work services, and pre-admission case management. The Manager acts as a liaison between patients and families, department staff, physicians and the healthcare team, community agencies, managed care representatives, skilled nursing facilities, and community agencies. The manager is responsible for establishing, implementing and monitoring best practice and established clinical standards to assure the quality of patient care and the financial integrity of the organization.
In this position you will:
Assists in developing departmental goals to meet the organizational mission, vision, strategic objectives
Maintains current knowledge of case management, utilization management, discharge planning and social work services, practices and standards of practice
Assures that department policies, procedures and protocols are developed, implemented and updated routinely and as needed
Assures the care delivery model maximizes a balance of service and cost efficiency based upon regulations, payer requirements and best practice in healthcare delivery
Provides management of the Case Management Department assuring departmental, organizational, state, federal, JCAHO and other regulatory requirements are achieved
Recommends, develops, updates and maintains measures of department performance including but not limited to financial and customer service measures compared to established benchmarks (national or regional) where available
Monitors over- and under- utilization of resources reporting routinely to the department Director and/or Medical Director
Monitors utilization management practices and medical necessity denials; assures denials are appealed concurrently whenever possible or timely retrospectively
Manages adherence to compliance with financial policies, payer contracts and contractual requirements related to care facilitation, discharge planning and utilization management.
Required qualifications for this position include:
Master's Degree in Social Work from an accredited school
6 years experience in Case Management
2 years supervisory/management experience, preferably in Case Management in an acute care setting
Knowledge of utilization management, case management, discharge planning, and care coordination practices and the outcomes/impact of these functions within the hospital is required
Effective communication (written and verbal) and interpersonal skills with all levels of internal and external customers is required. This includes but is not limited to: department staff, patients, families, physicians, clinical personnel, support and technical staff, external customers, payers, community providers and community agencies
Ability to effectively negotiate with physicians, staff, caregivers, community agencies and payers.
Must demonstrate ability to deal effectively with change and complex situations.
Must demonstrate knowledge of governmental, commercial and managed care payer’s requirements and regulations.
Must demonstrate understanding of case management standards of practice, case management strategies, and best practice protocols.
Licensed Independent Clinical Social Worker (LICSW) or Licensed Advanced Social Worker (LASW) with the Washington State Department of Health under Chapter 18.225 RCW required
Minimum 2 years in a licensed status required
About the First Hill Campus
The 697-bed tertiary-care center on the Swedish/First Hill campus is the flagship of the Swedish health-care system. Swedish/First Hill has one of the most active and advanced birthing programs in Washington state and houses a Level III neonatal intensive-care unit. More surgeries are performed each year at Swedish/First Hill than at any other facility in the region; volumes include more total joint replacements than any other medical center in the state.
We offer a full comprehensive range of benefits — see our website for details
Our nonprofit Mission is to improve the health and wellbeing of each person we serve. Our Vision is to demonstrate the highest-quality, best-value healthcare to all we serve.
Swedish is the largest nonprofit health care provider in the greater Seattle area. It is comprised of five hospital campuses (First Hill, Cherry Hill, Ballard, Edmonds and Issaquah); ambulatory care centers in Redmond and Mill Creek; and Swedish Medical Group a network of more than 118 primary care and specialty locations throughout the Puget Sound. Swedish employs more than 13,300 employees and 3,100 physicians and allied health professionals. Whether through physician clinics, education, research and innovation or other outreach, we’re committed to caring for the people in our region and beyond. Swedish is proud to be an Equal Opportunity Employer. Swedish does not discriminate on the basis of race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Case Management
Work Locations: First Hill Main Bldg (WA145) 747 Broadway Seattle, 98122
Req ID: 221463
Swedish Medical Center
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