Nurse Manager, Care Coordination

In collaboration with clinical and administrative leadership and as delegated by the Senior Nurse Director of Care Continuum Management, the Care Coordination Manager is responsible for the daily operations and performance of the Nurse Care Coordination team, including staffing assignments, leadership of high risk rounds, performance evaluation, education, training and mentoring of staff, program development, management of escalated care continuum issues, and direct patient assignments (as necessary). This includes managing the processes around assessment of patient/family care management needs, oversight of utilization review, and implementation of multi-disciplinary, high quality care transition between levels of care.

The Care Coordination Manager will oversee a team with responsibility for:

1. Care transition management activities including care coordination, utilization management, discharge planning and community resources;
2. Delegating activities that can be provided by a non-licensed resource specialist,
3. Communicating with patients and families, and a multi-disciplinary team;
4. Other key activities identified as critical through innovation and continuous development of the program.

Care Continuum Management Activities

• Accountable for ensuring that appropriate care coordination and transition management is provided for patients and families to promote optimal patient outcomes and experience
• Plans, supervises, and evaluates all work assignments; ensures timeliness and appropriateness of care coordinationinterventions
• Assists staff with coordination of complex cases and referrals and transitions to community, home and post-acute facilitie
• Leads high risk rounds to aid in complex planning and decision-making, maintain staff accountability, and facilitate timely discharge
• Collaborates and leads initiatives with clinical operations teams, including clinical service director and nursing partners
• May perform coordination and activities pertinent to licensure as appropriate to maintain professional expertise, competency and licensing necessary to fulfill job responsibilities and to direct the provision of care on the units and within the Care Continuum Management department
• In collaboration with other Care Coordination Managers and the Directors of Care Continuum Management, develops appropriate education programs in accordance with system, departmental and service-based standards
• Manages escalations of challenging cases from team members and service-based clinical operations team.
• Performs other duties as requested or required

Supervisory/ Staff Management

• Fosters a positive working environment that is patient-focused and supports excellence of care management across the continuum.
• In collaboration with the Senior Nurse Director of Care Continuum Management and Human Resources, is accountable to hire, train, supervise, counsel, discipline, and terminate assigned staff as appropriate.
• In collaboration with the Care Continuum Management Operations Manager, completes and approves time changes, conference days, vacation schedule, and coordinates daily staffing as necessary.
• Oversees the development of training materials and process for onboarding of staff.
• Insures successful orientation and continuous education and development of self and others.
• Communicates goals, objectives, accountabilities, priorities, and authority parameters to assigned staff.
• Tracks staff key performance indicators related to care management or utilization management to identify opportunities for staff coaching and/or local process improvement.
• Completes performance planning and appraisal forms and reviews with staff as delegated.

Organizational Leadership

• Plans and directs enterprise wide committees and/or teams as needed for system-wide or hospital- based imperatives; leads committee; coordinates statistical data; presents reports.
• Responds to and resolves immediate issues requiring management intervention or clinical consultation.
• Manages patient complaints and care team feedback.
• Manages optimum relationships with clinical operations teams, physicians, nurses, & ancillary staff to effectuate cost containment objectives around highest quality and efficient care.
• Liaisons with internal departments and external resources, i.e. health plans and other payer types on behalf of hospital patients as indicated; collaborates with inpatient hospital team, other medical departments and physician advisors as needed.
• Manages ongoing performance improvement of team based on Care Continuum Management objectives.

Financial Management

• Actively participates in budget process.
• Assists in development of and monitors and controls payroll and non-payroll budget for area to provide efficient, cost-effective patient services.

Quality & Compliance

• Defines, develops and manages policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies.
• Ensures ongoing effectiveness of quality management program for the department, to include a selection of key processes and indicators of quality, monitoring, and evaluating improvement.
• Incorporates quality improvement findings into daily operations and strategic planning for specific areas
• Supports The Joint Commission efforts and ensures appropriate review and updates of the hospital plan for patient care and services
• Ensures consistent communicates telephonically and electronically with outpatient providers in an effort to enhance the coordination and quality of the continuum of care

Self-Development

• Identifies and participates in educational opportunities that would enhance effectiveness in the role.
• Pursues a continuing program of self-development to remain cognizant of current trends and new methods within the profession and health care environment.

Qualifications

• Bachelor's in Nursing (BSN) required, Master's degree in a related field, preferred.
• 2 years of experience in a hospital/multidisciplinary health care setting preferred.
• Previous leadership experience with demonstrated management ability is preferred.
• Comprehensive knowledge of care coordination, utilization management, and utilization of community resources.
• Current registration in nursing in the Commonwealth of Massachusetts.
• Current certification required. Certification must be maintained while employed in this position.

Skills and Abilities Required:

• Ability to handle teams with responsibility for a portfolio of patients.
• Ability to work within a specialized setting and multiple disciplines.
• Strong communication skills.
• Strong management skills.
• Attention to detail.
• Excellent interpersonal skills including negotiation skills.
• Sound analytical and quantitative skills.
• Diplomacy and tolerance for ambiguity.

Brigham and Women's Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.