Lead Care Management Techynician Full Time Days

Description

DMC Sinai-Grace Hospital is DMC’s largest hospital, offering a comprehensive heart center, cancer care, gerontology, emergency medicine, obstetrics/gynecology and cosmetic services. Sinai-Grace’s joint replacement program features a revolutionary minimally invasive knee and hip replacement surgery that attracts patients from all over the country. Sinai-Grace operates more than 21 outpatient care sites and ambulatory surgery centers throughout Wayne and Oakland Counties and is one of 10 hospitals in the nation to be awarded a Robert Wood Johnson Foundation grant to help set the standards of cardiac care for hospitals and physicians throughout the nation.

Summary Description

Under limited direction, facilitates and enhances hospital efficiency and patient satisfaction by assuring and expediting appropriate assignment/placement of patients to hospital services, including all admissions, e.g., direct admits, transfers, same-day-surgery, as emergency and other intra-departmental admissions/transfers. Promotes consistent, application, effective processes and clinical service accountability for the Bed Management Process.

Assists in the implementation of policies and procedures related to the Bed Management Process. Functions as a lead and resource person and utilizes expertise in bed management to lead the team. Participates in the selection, scheduling, educating, evaluating, and monitoring the work of Care Management Technician personnel. Performs duties of a Care Management Technician, as needed.

Performs various functions related to appropriate placement of patients to hospital services, including hospital-wide decisions regarding direct admits, transfers, pre-admissions review, as well as emergency and other intra-departmental admissions. Assigns patients to appropriate nursing unit according to knowledge of hospital bed capacity and utilization.

Maintains contact with numerous hospital departments such as patient management (admitting), nursing units, emergency department and other points of entry into the hospital in order to effectively utilize hospital capacity. Expedites patient admissions/transfers, as well as coordinates problem resolution involving consideration of acuity (via consultation with clinical personnel) of patient, diagnosis, Length of Stay (LOS) in ED as applicable, and preparation of vacant beds.

Routinely interacts with all disciplines including ED physicians, other department managers/directors, and unit personnel to resolve and coordinate patient placement issues. Frequently interacts with senior leadership during bed placement shortage and participates in the decision-making process to ensure coordination of patients based upon needs.

Develops and monitors resource utilization and manages appropriate scheduling adjustments. Monitors completion and accuracy of reports and takes corrective action. Coordinates work procedures and protocols with other departments as required. Coordinates and participates in special projects, as assigned. Assists with insurance verification and/or registration as necessary.

Minimum Qualifications

1. High school diploma or equivalent. Medical Assistant certification, license to practice as a Licensed Practical Nurse (LPN), or college coursework in heath care preferred. Additional training in computer applications preferred.

2. Three to five years related experience in an outpatient clinic or hospital setting, including six to twelve months of data entry experience. Experience with emergency department admissions and knowledge of third party payers preferred.

3. One to two years work experience in an insurance, medical records, billing or related area desirable.

4. Working knowledge of medical terminology desired.

Skills Required

1. Analytical skills and abilities to assess hospital capability, service options, resolve problems that typically involve many departments working together, determine patient needs, understand third party regulations and processes, identify options to meet patient needs.

2. Interpersonal and communication skills to effectively collaborate and negotiate with all types of hospital personnel (including department managers/directors), medical staff (including department chiefs), patients, and families; and to effectively communicate sensitive or confidential information with patient, patient family and various levels of health facility personnel, and a variety of external organizations.

3. Ability to resolve conflict, including situations where there may be conflicting priorities.

4. Skills necessary to work independently and coordinate/prioritize multiple tasks.

5. Leadership skills necessary to guide and coordinate the work and activities of employee teams.

6. Ability to understand and apply various third party payor requirements, verification procedures and benefits.

7. Ability to adapt to technologies used in work environment.

8. Ability to work within a complex environment and handle multiple priorities.