Manager of Case Management

Case Management

8am-430pm; Full time

Standard Hours/Week:

The Manager is responsible for promoting and demonstrating Parrish Healthcare's Culture of Choice®; actively and effectively participates in ensuring strategic goals and objectives are met or exceeded; provides the management and oversight necessary to ensure assigned functional area(s) in Case Management and Social Work have the proper resources, metrics and talent in place to effectively fulfill our mission to provide Healing Experiences for Everyone all the Time® and achieve organizational strategic (Game Plan) goals. The Manager assumes 24-hour responsibility and accountability for assigned functional area(s). This position reports to the Assistant VP of Nursing Administration/CNO.

  • Manages operational planning within assigned functional area(s) to anticipate current /future service solutions.
  • Manages implementation of growth strategies to support achievement of Parrish Healthcare Game Plan goals.
  • Assures the achievement of departmental dashboard metrics within each strategic pillar (People, Service, Quality, Growth, Finances); takes immediate and effective steps to assure national benchmarks are achieved or sustained.
  • Manages departmental systems, processes, policies, and procedures that result in assigned area(s) of responsibility and care partners always providing excellent service excellence as measured by national best-practice benchmarks.
  • Manages specific UR activities, analyzes admissions, continued stays, facilitates required information for third party payers, appeal denials, and acts as advisor to medical staff. Analyzes and submits monthly statistical report to the CFO regarding admission and observation appropriateness, LOS avoidable days, appeal denials, resource management efforts and other issues, as well as report at Utilization Review Committee. Educates providers and other care partners regarding the requirements of the hospital's utilization review program, criteria and guidelines utilized, and compliance to payer regulations/contracts. Supports pathway development efforts to enhance utilization management, resource management, and discharge planning. Works in conjunction with the Quality Department to identify quality concerns as appropriate.
  • Manages systems, processes, policies, and procedures that result in a continuous improvement environment within which assigned area(s) and care partners always achieve national best/leading-practice standards for quality and safety as measured by CMS, Joint Commission, and other regulatory agencies pertinent to areas of responsibility, holding self and others accountable for actions and outcomes.
  • Responsible for the adherence to all Parrish Healthcare policies and procedures as well as regulations and codes established by federal, state, and local governments affecting professional practice and industry regulations. Leads necessary certification, accreditation, and audit procedures; and ensures that reports required by regulatory agencies are prepared and submitted within established timeframes.
  • Manages systems, processes, policies, and procedures that result in an inclusive, collaborative, healing work environment within which national best/leading-practice standards for employee engagement are achieved as measured by effective performance management, problem-solving and conflict resolution, mentoring aspiring care partners, and inspiring care partner commitment to our mission, vision, values, and safe care pledge.
  • Maintains skills and knowledge within professional practice for self and for assigned care partners; able to step in and serve as back up to assigned care partners to cover staffing needs as necessary.
  • Manages systems, processes, policies and procedures that result in effective planning and administration of annual budget(s); productive, cost efficient and effective operations within assigned functional area(s); and effective corrective actions for any operating expenses that deviate from budget.

Formal Education:
  • Bachelor's Degree in Nursing (BSN) required. Associate's Degree in Nursing (ASN) with two years supervisory or management experience may be substituted for BSN.

Work Experience:
  • 3 years to < 5 years of experience in related area with two of those years being supervisory or management experience.

Required Licenses, Certifications, Registrations:
  • State of Florida RN License required
  • Current Sigma Six Green Belt certification, or required within one (1) year of employment
  • Certified Case Manager preferred

Parrish Healthcare is a caring community of healthcare professionals passionate about excellence and fulfilling our mission of providing Healing Experiences For Everyone All The Time®.

Parrish Healthcare has a Culture of Choice®. This means a we have a healing work environment that empowers people to aspire to be their very best. We partner passionate, talented and skilled people in the right role with the right resources. We provide a clear and strategic direction to achieve superior results on behalf of the communities we serve.